PD-L1 Tumor Proportion Score (TPS) is the primary predictive biomarker for pembrolizumab...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-PDL1-TPS-NSCLC |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-05-07 | actionability review required |
| Diseases | DIS-NSCLC |
| Sources | SRC-ESMO-NSCLC-METASTATIC-2024 SRC-KEYNOTE-024-RECK-2016 SRC-KEYNOTE-042-MOK-2019 SRC-KEYNOTE-189-GANDHI-2018 SRC-KEYNOTE-407-PAZ-ARES-2018 SRC-NCCN-NSCLC-2025 |
Actionability Facts
| Biomarker | BIO-PDL1-TPS |
|---|---|
| Disease | DIS-NSCLC |
| ESCAT tier | IA |
| Recommended combinations | pembrolizumab monotherapy (TPS≥50% 1L per SRC-KEYNOTE-024-RECK-2016, SRC-NCCN-NSCLC-2025), pembrolizumab + carboplatin + pemetrexed (TPS≥1% non-sq 1L per SRC-KEYNOTE-189-GANDHI-2018), pembrolizumab + carboplatin + paclitaxel/nab-paclitaxel (TPS≥1% sq 1L per SRC-KEYNOTE-407-PAZ-ARES-2018) |
| Evidence summary | PD-L1 Tumor Proportion Score (TPS) is the primary predictive biomarker for pembrolizumab selection in metastatic NSCLC without driver alterations. Three threshold-stratified eligibility bands: TPS ≥50% — pembrolizumab monotherapy 1L preferred (KEYNOTE-024; mPFS 10.3 vs 6.0 mo, HR 0.50); TPS ≥1% — pembrolizumab + carboplatin + pemetrexed (non-sq, KEYNOTE-189) or pembrolizumab + carboplatin + paclitaxel/nab-paclitaxel (sq, KEYNOTE-407); TPS 1-49% — chemo-IO combination preferred over pembro mono. Testing by IHC 22C3 pharmDx mandatory on FFPE specimen. Threshold-gated indication selection is performed by the algorithm layer (ALGO-NSCLC, IND-NSCLC-PDL1-HIGH-MET-1L, IND-NSCLC-PDL1-LOW-NONSQ-MET-1L); this BMA entry surfaces ESCAT tier context only. |
Notes
Variant_qualifier null — TPS is a continuous score (0-100%); threshold gating enforced by the algorithm/indication layer. TPS ≠ CPS: TPS counts only PD-L1+ tumor cells; CPS additionally counts PD-L1+ immune cells. EGFR/ALK/ROS1/BRAF/KRAS/MET driver alterations take priority over PD-L1 TPS — algorithm checks driver status first.
Used By
No reverse references found in the YAML corpus.