PErsonalized TReatment for Endometrial Carcinoma

Endometrial carcinomas can be classified into four molecular subgroups, i.e. mismatchrepair deficient (MMR‐D), p53 abnormal (p53 abn), polymerase‐ϵ (POLE) ultramutated, and"no specific molecular profile" (NSMP). Molecular subgroups can be considered to bedistinct diseases as they are associated with different clinicopathologiccharacteristics, prognoses and, possibly, responses to adjuvant therapy. Molecularclassification of endometrial carcinoma is recommended to be implemented in routineclinical practice to improve prognostication and triage to adjuvant therapy. ThePErsonalized TReatment for Endometrial Carcinoma (PETREC) trial, led by the FinnishGynecologic Oncology Group (FINGOG), is a multicenter prospective clinical trial forwomen with stage I‐II molecular integrated high‐intermediate or high‐risk endometrialcarcinoma. The efficacy of chemotherapy vs. chemoradiotherapy is compared in p53 abnsubtype and nonendometrioid carcinomas, and vaginal brachytherapy vs. whole pelvicradiotherapy in MMR‐D and NSMP molecular subgroups. Patients who consent to follow‐upwithin the trial but not to randomization are treated as recommended in multidisciplinarymeetings and enrolled for follow‐up only (comprehensive cohort study design). The primaryoutcome is the 5‐year cumulative incidence of disease recurrence. Secondary outcomes arevaginal, pelvic, and distant recurrence rates, 5‐year recurrence‐free and overallsurvival, adverse events, and patient‐reported symptoms and quality of life. The findingsof the trial may eventually help decrease under‐ and overtreatment and, consequently,improve patient outcome and decrease treatment‐associated adverse effects.