PD-L1 expression high OR progression on first asparaginase-based regimen — pembrolizumab/...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-NK-T-NASAL-TRANSFORMATION-PROGRESSION`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-NK-T-NASAL`
Sources	`SRC-ESMO-PTCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	PD-L1 expression high OR progression on first asparaginase-based regimen — pembrolizumab/sintilimab + chidamide salvage shows ORR 50-60% in this setting.
Clinical direction	investigate
Category	transformation-progression

Trigger Logic

{
  "any_of": [
    {
      "finding": "pd_l1_high_expression",
      "value": true
    },
    {
      "finding": "asparaginase_regimen_failure",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

PD-1 inhibitor activity in NK/T-nasal exceptional (50-60% ORR) — this is a 2L decision driver. 1L Algorithm unaffected.

Used By

Algorithms

ALGO-NK-T-NASAL-2L - ALGO-NK-T-NASAL-2L