• POLE ultramutation (POLEmut): A pathogenic mutation in the proofreading part of the POLE gene gives an endometrial tumour hundreds of mutations per megabase and, paradoxically, one of the best outlooks of any womb cancer, so finding it can spare a woman chemotherapy or radiotherapy.
• Microsatellite-stable (MSS) / mismatch-repair proficient (pMMR): The 'normal' result on the mismatch-repair test: the tumour has intact DNA spell-checking and few mutations.
• Radiotherapy: Using high-energy X-rays or particles to damage the DNA of cancer cells in a precisely aimed volume of the body.
• Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR): Microsatellite instability is the mark of a broken DNA spell-checker (loss of MLH1, MSH2, MSH6 or PMS2) that leaves thousands of mutations, so the tumour displays abnormal proteins that T cells can recognise.

Biomarker results to ask for: MMR and MSI status (drives the size of immunotherapy benefit), p53 and POLE (molecular class), HER2 immunohistochemistry (trastuzumab deruxtecan), Oestrogen and progesterone receptors (endocrine therapy), PD-L1 (not required), TROP2 and folate receptor alpha (antibody-drug conjugate trials), CA-125 for monitoring.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• First line, dMMR: Carboplatin-paclitaxel with dostarlimab (RUBY) or pembrolizumab (NRG-GY018), then maintenance immunotherapy for up to three years or two years respectively. (Dostarlimab, Pembrolizumab, Carboplatin, Paclitaxel / nab-paclitaxel, RUBY / ENGOT-EN6 / GOG-3031, NRG-GY018 / KEYNOTE-868, Chemotherapy + PD-1/PD-L1 blockade, first-line advanced endometrial cancer, Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR))
• First line, pMMR: Carboplatin-paclitaxel with pembrolizumab or dostarlimab, or durvalumab followed by durvalumab-olaparib maintenance (DUO-E); trastuzumab added for HER2-positive serous carcinoma. (Pembrolizumab, Dostarlimab, Durvalumab, Olaparib, DUO-E / GOG-3041 / ENGOT-EN10, Trastuzumab, Microsatellite-stable (MSS) / mismatch-repair proficient (pMMR))
• Isolated pelvic recurrence: Radiotherapy with brachytherapy for vaginal recurrence after surgery alone; exenteration in selected central recurrences after radiotherapy. (IMRT / IGRT (modern external beam), Brachytherapy, Radiotherapy)
• After platinum, pMMR: Lenvatinib with pembrolizumab (KEYNOTE-775); trastuzumab deruxtecan for HER2-expressing tumours; aromatase inhibitors or progestins for low-grade receptor-positive disease. (Lenvatinib, Pembrolizumab, KEYNOTE-775 / Study 309, Trastuzumab deruxtecan, DESTINY-PanTumor02, Letrozole (and other aromatase inhibitors), Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD))
• After platinum, dMMR without prior immunotherapy: Single-agent dostarlimab or pembrolizumab. (Dostarlimab, Pembrolizumab, Immune checkpoint inhibitors)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.