The ProMisE molecular classifier categorises endometrial cancers into four prognostic groups. Which molecular group carries the BEST prognosis with near-universal cure?
- A Mismatch repair deficient (MMRd)
- B Copy number low, p53 wildtype (NSMP)
- C POLE ultramutated (POLE-mutant) ✓
- D Copy number high, p53-abnormal (p53-abn)
Correct answer: C. POLE ultramutated (POLE-mutant)
Explanation
POLE ultramutated endometrial cancers have an exceptionally favourable prognosis with near-universal disease-free survival regardless of histological grade or stage. POLE mutations cause a hypermutator phenotype with abundant neoantigens and strong anti-tumour immunity. The p53-abnormal group (serous-like) carries the worst prognosis. MMRd has intermediate prognosis and predictive value for immunotherapy response (pembrolizumab). NSMP represents the largest heterogeneous group.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.