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12 standard-of-care settings across 6 lines and 5 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers | HER2 | MSI-H / dMMR | pMMR / MSS | Risk group |
|---|---|---|---|---|---|
| Screening, prevention and diagnosis | 2 | · | · | · | · |
| Early / localised | 2 | · | · | · | 1 |
| Locally advanced | · | · | · | · | 1 |
| Second line | 2 | · | 1 | 1 | · |
| Special situations | 1 | · | · | · | · |
| Other settings | · | 1 | · | · | · |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Prevention and hereditary risk | Universal MMR testing of tumours to identify Lynch syndrome; risk-reducing hysterectomy and salpingo-oophorectomy for Lynch carriers after childbearing; levonorgestrel IUD and weight management reduce risk; no screening for average-risk women. | NCCN · 2A | 94 | |
| All comers | Diagnosis and staging | Endometrial biopsy for postmenopausal bleeding; MRI for myometrial and cervical invasion; molecular classification (p53, MMR IHC, POLE sequencing) on the diagnostic specimen. | NCCN · 2A | 95 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Early | Hysterectomy; adjuvant therapy by molecular class. | NCCN Guidelines: Uterine Neoplasms | - | |
| All comers | Early stage surgery | Minimally invasive total hysterectomy and bilateral salpingo-oophorectomy with sentinel lymph node mapping (FIRES, SENTOR); omentectomy for serous histology. | NCCN · 1 | 83 | |
| Risk group | Adjuvant, low and intermediate risk | Observation (low risk, POLEmut) or vaginal brachytherapy (intermediate risk; PORTEC-2); molecular class may de-escalate (PORTEC-4a). | NCCN · 1 (brachytherapy) | 40 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Risk group | Adjuvant, high risk (stage III, serous, p53abn, deep invasion grade 3) | Chemoradiation plus carboplatin-paclitaxel (PORTEC-3) or chemotherapy alone (GOG-258); pembrolizumab or dostarlimab added for stage III-IV per RUBY/GY018 eligibility. | NCCN · 1 | 98 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Advanced/recurrent | Chemotherapy + dostarlimab or pembrolizumab; lenvatinib-pembrolizumab; T-DXd if HER2+. | NCCN Guidelines: Uterine Neoplasms | 98 | |
| All comers | Advanced or recurrent, first line (any MMR status) | Carboplatin-paclitaxel plus dostarlimab (RUBY), pembrolizumab (NRG-GY018/KEYNOTE-868), or durvalumab (DUO-E; dMMR in the US), continued as maintenance up to 2-3 years. | NCCN · 1ESMO-MCBS · 4 (dMMR) | 98 | |
| MSI-H / dMMR | Recurrent, dMMR, after chemotherapy | Single-agent PD-1 blockade (dostarlimab GARNET, pembrolizumab) if immunotherapy-naive; otherwise chemotherapy or trials. | NCCN · 1 | 98 | |
| pMMR / MSS | Recurrent, pMMR, after platinum | Lenvatinib + pembrolizumab (KEYNOTE-775) if not previously given immunotherapy; T-DXd if HER2 IHC 3+; chemotherapy (doxorubicin, weekly paclitaxel); hormonal therapy for low-grade ER-positive disease. | NCCN · 1 (lenvatinib-pembrolizumab) | 98 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Fertility-sparing (grade 1, stage IA, no invasion) | Progestin (oral or IUD) with re-biopsy every 3-6 months; hysterectomy after childbearing. | NCCN · 2B | 67 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| HER2 | HER2-positive serous | Trastuzumab with carboplatin-paclitaxel (randomised phase 2) or T-DXd for IHC 3+ after prior therapy. | NCCN · 2A | 97 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.