Refining Adjuvant Treatment IN Endometrial Cancer Based On Molecular Features (RAINBO) - NSMP-ORANGE Trial: Comparing Radiotherapy With Oral Progestin Tablets vs. the Current Standard Care, Radiotherapy and Chemotherapy, in Patients With NSMP Endometrial Cancer

This study is for women aged 18 or older who have recently had surgery to remove womb cancer. To be considered, your cancer needs to be a specific type and have certain characteristics that doctors identify through special tests (called molecular features). Your doctors will also need to confirm that the cancer has not spread to other parts of your body and that you are generally well enough to take part in a study.

You will have already had an operation called a hysterectomy, which removes the womb and usually the ovaries and fallopian tubes. It's important that no cancer was left behind after this surgery. The study also requires you to have a good general health status, as measured by a scale called WHO performance status (scores of 0 or 1 mean you're able to carry out most or all daily activities).

There are also some reasons why you might not be able to join. For example, if you've had certain other cancers recently, or if you've had radiation treatment to your pelvis before. Also, if you've had serious blood clots (like angina or a heart attack) in the last six months, or have ongoing issues with blood clots, you wouldn't be able to take part.

If you join this study, you'll be randomly assigned to one of two treatment groups, like flipping a coin. One group will receive the current standard treatment, which is radiotherapy followed by chemotherapy. The other group will receive radiotherapy followed by daily hormone tablets (either medroxyprogesterone acetate or megestrol acetate).

Before you start, and throughout the study, you'll have regular hospital visits for assessments, including blood tests and scans, to check how you're responding to treatment and to monitor for side effects. You'll also be asked to provide tissue samples from your surgery for further research. The specific number of visits and tests will be explained in detail by the study team. Treatment usually starts within 10 weeks after your surgery, and you will be followed up for an extended period to see how you're doing in the long term. You will need to consent to share your data for the broader research programme.