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Documented progressive disease (PD) on or within 6 months of prior anti-PD-1 / anti-PD-L1...

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

Red Flag Origin

Trigger Logic

{
  "any_of": [
    {
      "finding": "prior_anti_pd1_progression",
      "value": true
    },
    {
      "finding": "prior_anti_pdl1_progression",
      "value": true
    },
    {
      "all_of": [
        {
          "finding": "prior_io_received",
          "value": true
        },
        {
          "comparator": "<",
          "finding": "io_treatment_free_interval_months",
          "threshold": 6
        },
        {
          "finding": "best_response_to_io",
          "value": "PD"
        }
      ]
    }
  ],
  "type": "composite_score"
}

Notes

Primary IO resistance is operationally distinct from acquired resistance (PD after initial response >6 months). SITC consensus (Kluger 2020) defines primary resistance as PD within 6 months of IO start. Subsequent options vary by tumor: melanoma — BRAF/MEKi if V600E, T-VEC, TIL therapy at trial centers, IL-2; NSCLC — docetaxel ± ramucirumab, ADC if HER2/TROP2; urothelial — enfortumab vedotin + pembrolizumab combination remains active even after IO-mono PD per EV-302; RCC — cabozantinib monotherapy or lenvatinib + everolimus. IO-rechallenge is generally not standard but may be considered after >6 months treatment-free + non-PD discontinuation reason.

Used By

Algorithms

• ALGO-ENDOMETRIAL-2L - ALGO-ENDOMETRIAL-2L