Given the results of PORTEC-4A, what adjuvant therapy, if any, would you offer a patient with a POLE-mutant endometrial cancer who also has a p53 mutation and substantial (>5 foci) of LVSI?

When you have dual mutation, the better of the two mutations drives the outcome, so it would be treated like a POLE-type. If substantial LVSI and pathological nodal assessment are done, I would favor Brachy alone. If nodes are not assessed, I would favor EBRT. The link below has references about dua...