# Endometrial cancer molecular classes (POLEmut, MMRd, p53abn, NSMP)

Source: https://onco.cc/terms/endometrial-molecular-classes/  
OnCo record `endometrial-molecular-classes` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Four groups defined by a few tests that predict outcome better than the microscope: POLE-mutated (excellent), mismatch-repair deficient, p53-abnormal (worst), and 'no specific profile'.

## Summary

From TCGA (Nature 2013) via the ProMisE classifier (Talhouk 2015) into the WHO 2020 classification and ESGO/ESTRO/ESP 2021 guidelines. POLE-ultramutated (~7%) almost never relapses and may need no adjuvant therapy; MMRd (~25-30%) responds to immunotherapy; p53abn (~15%; includes most serous) benefits from chemotherapy (PORTEC-3) and often carries HER2 amplification; NSMP (~50%) is heterogeneous, with L1CAM and ER status refining risk. Molecular-class-directed adjuvant trials (RAINBO programme, PORTEC-4a) are ongoing.

## Fields

- Kind: Term
- Last checked: 2026-09-07
- Also known as: ProMisE; ProMisE classifier; molecular classification of endometrial cancer; TCGA endometrial subtypes; WHO 2020 endometrial molecular classification; endometrial molecular class; molecular class

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Endometrial_cancer
- TCGA, Nature 2013: https://www.nature.com/articles/nature12113

## Connected records

- cancers: [Endometrial cancer](https://onco.cc/cancers/endometrial/), [Endometrial cancer with no specific molecular profile](https://onco.cc/cancers/endometrial-nsmp/), [Mismatch-repair-deficient endometrial cancer](https://onco.cc/cancers/endometrial-mmr-deficient/), [p53-abnormal endometrial cancer, including uterine serous carcinoma](https://onco.cc/cancers/endometrial-p53-abnormal/), [POLE-ultramutated endometrial cancer](https://onco.cc/cancers/endometrial-pole-ultramutated/)
- targets: [HER2](https://onco.cc/targets/her2/), [TP53](https://onco.cc/targets/tp53/)
- terms: [Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)](https://onco.cc/terms/msi/), [No specific molecular profile (NSMP) endometrial cancer](https://onco.cc/terms/nsmp/), [POLE ultramutation (POLEmut)](https://onco.cc/terms/pole-ultramutation/)
- trials: [PORTEC-3](https://onco.cc/trials/portec-3/)
- ideas: [HER2 ADCs as standard for HER2-positive serous endometrial cancer](https://onco.cc/ideas/idea-her2-adc-serous-endometrial/), [Molecular-class-directed adjuvant therapy in endometrial cancer](https://onco.cc/ideas/idea-molecular-class-adjuvant-endometrial/)
- pathways: [Mismatch repair & microsatellite instability](https://onco.cc/pathways/mismatch-repair-msi/)
- drugs: [VENTANA MMR RxDx Panel](https://onco.cc/drugs/ventana-mmr-rxdx/)

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