Preetam Jain: Personalized Endometrial Cancer Treatment Based on 4 Key Molecular Subgroups

Preetam Jain, Consultant Medical Oncologist and Hemato-Oncologist at Bombay Hospital and Medical Research Centre, shared a post on X:

“‘Same Stage ≠ Same Treatment’ ​

Endometrial cancer treatment is evolving rapidly. We are moving beyond just stage and grade to Molecular Classification, allowing us to personalize treatment for every patient. ​

Here is a quick breakdown of the 4 key molecular subgroups: ​

1. POLE-mutated: Best prognosis. Even high-grade tumors may NOT need aggressive adjuvant treatment. “Looks bad under microscope, behaves good clinically.”
2. MMR-Deficient (MMRd): Intermediate prognosis. Crucial for Lynch Syndrome screening. Highly responsive to immunotherapy if it recurs. “Think genetics. Think immunotherapy.”
3. NSMP (No Specific Molecular Profile): Intermediate risk. Traditional pathology (Stage, Grade, LVSI) still heavily drives management here.
4. p53-Abnormal: Highest risk. Requires escalation of adjuvant treatment. “Treat aggressively.” ​

Modern Endometrial Cancer Care = Stage + Grade + LVSI + Myometrial invasion + Molecular profile.

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