Treatment Option for Deficient Mismatch Repair (dMMR) and Proficient Mismatch Repair (pMMR) in Endometrial Cancer

Endometrial cancer (EC) is one of the most common cancers in women.Molecular classification, particularly mismatch repair (MMR) status, is emerging as a key determinant in treatment decision-making.Tumors that exhibit deficient MMR (dMMR) are more likely to have microsatellite instability (MSI-H) and show increased responsiveness to immune checkpoint inhibitors (ICIs) such as pembrolizumab and dostarlimab.In contrast, proficient MMR (pMMR) tumors generally show limited immunogenicity and benefit less from immunotherapy, relying mainly on conventional modalities such as surgery, radiotherapy, and carboplatin-paclitaxel chemotherapy.Recent clinical trials have investigated the combination of immunotherapy with chemotherapy and targeted agents, aiming to extend the benefits of immunotherapy to a wider patient population.However, several challenges remain, including optimal patient selection, immune-related toxicity, therapeutic resistance, and gaps in access to molecular diagnostics.Continued research into genomic biomarkers, next-generation immunotherapies, and personalized treatment strategies offers promising avenues to improve outcomes in dMMR and pMMR EC.