# Combined positive score (CPS) Source: https://onco.cc/terms/cps/ OnCo record `cps` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence. ## TL;DR A PD-L1 score that counts stained tumour cells and immune cells together. ## Summary The combined positive score (CPS) is a PD-L1 measure that counts stained tumour cells together with stained lymphocytes and macrophages, divides by the number of viable tumour cells and multiplies by 100, using the 22C3 assay. A CPS of 10 or more defines Pembrolizumab eligibility in Triple-negative breast cancer (TNBC) under KEYNOTE-355, while a CPS of 1 or more is the threshold in head and neck, gastric and cervical cancers. It differs from the Tumour proportion score (TPS), which counts tumour cells only, and from the SP142 immune-cell score used for atezolizumab. The score is attached to the PD-L1 target and is referenced by the Gastric, Oesophageal, Ovarian, Cervical and Head and neck cancer entries and by the KEYNOTE-048, KEYNOTE-689, KEYNOTE-590, KEYNOTE-859 and CheckMate 649 trials. ## Fields - Kind: Term - Last checked: 2026-09-04 ## Sources - Wikipedia: https://en.wikipedia.org/wiki/PD-L1 - Wikipedia: https://en.wikipedia.org/wiki/PD-L1 ## Connected records - targets: [PD-L1](https://onco.cc/targets/pdl1/) - drugs: [PD-L1 IHC 22C3 pharmDx](https://onco.cc/drugs/dako-pd-l1-22c3-pharmdx/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/) - trials: [CheckMate 649](https://onco.cc/trials/checkmate-649/), [DIAMOND](https://onco.cc/trials/diamond/), [IMpassion131](https://onco.cc/trials/impassion131/), [KEYNOTE-048](https://onco.cc/trials/keynote-048/), [KEYNOTE-119](https://onco.cc/trials/keynote-119/), [KEYNOTE-355](https://onco.cc/trials/keynote-355/), [KEYNOTE-590](https://onco.cc/trials/keynote-590/), [KEYNOTE-689](https://onco.cc/trials/keynote-689/), [KEYNOTE-826](https://onco.cc/trials/keynote-826/), [KEYNOTE-859](https://onco.cc/trials/keynote-859/), [KEYNOTE-B96 / ENGOT-ov65](https://onco.cc/trials/keynote-b96/), [ORIENT-16](https://onco.cc/trials/orient-16/) - cancers: [Cervical cancer](https://onco.cc/cancers/cervical/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [HPV-associated vulvar squamous cell carcinoma](https://onco.cc/cancers/hpv-associated-vulvar-cancer/), [HPV-independent vulvar squamous cell carcinoma (p53-mutant)](https://onco.cc/cancers/hpv-independent-vulvar-cancer/), [Immunomodulatory triple-negative breast cancer (IM)](https://onco.cc/cancers/tnbc-immunomodulatory/), [Metastatic triple-negative breast cancer](https://onco.cc/cancers/tnbc-metastatic/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Ovarian cancer](https://onco.cc/cancers/ovarian/), [PD-L1-high gastric cancer](https://onco.cc/cancers/gastric-pdl1-high/), [Recurrent or metastatic head and neck squamous cell carcinoma](https://onco.cc/cancers/recurrent-metastatic-hnscc/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/), [Vulvar cancer](https://onco.cc/cancers/vulvar/) - terms: [Immune checkpoint](https://onco.cc/terms/immune-checkpoint/), [PD-L1 assay discordance (SP142, SP263 and 22C3 in breast cancer)](https://onco.cc/terms/pd-l1-assay-discordance/), [PD-L1 combined positive score 10 in triple-negative breast cancer](https://onco.cc/terms/pd-l1-cps-10-tnbc/), [PD-L1 expression testing (22C3, SP142, SP263)](https://onco.cc/terms/pd-l1-testing/), [Triple-negative breast cancer trials open today (registry snapshot and UK sites)](https://onco.cc/terms/tnbc-trials-open-today/), [Tumour proportion score (TPS)](https://onco.cc/terms/tps/) - key papers: [Biomarkers for Systemic Therapy in Metastatic Breast Cancer: ASCO Guideline Update](https://onco.cc/key-papers/paper-asco-biomarkers-metastatic-breast-cancer-guideline-jco-2022/), [CheckMate 649: nivolumab plus chemotherapy as first treatment for advanced gastric, gastro-oesophageal junction and oesophageal adenocarcinoma](https://onco.cc/key-papers/paper-checkmate-649-lancet-2021/), [Comparison of SP142 and 22C3 PD-L1 assays in a population-based cohort of triple-negative breast cancer patients in the context of their clinically established scoring algorithms](https://onco.cc/key-papers/paper-sigurjonsdottir-sp142-22c3-tnbc-bcr-2023/), [KEYNOTE-048: pembrolizumab, alone or with chemotherapy, as first treatment for recurrent or metastatic head and neck cancer](https://onco.cc/key-papers/paper-keynote-048-lancet-2019/), [KEYNOTE-522: adding pembrolizumab before and after surgery in early triple-negative breast cancer](https://onco.cc/key-papers/paper-keynote-522-nejm-2022/), [KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancer (overall survival)](https://onco.cc/key-papers/paper-keynote-a18-os-lancet-2024/), [KEYNOTE-A18: pembrolizumab with chemoradiotherapy for locally advanced cervical cancer (progression-free survival)](https://onco.cc/key-papers/paper-keynote-a18-pfs-lancet-2024/), [PD-L1 Immunohistochemistry Assay Comparison in Atezolizumab Plus nab-Paclitaxel-Treated Advanced Triple-Negative Breast Cancer](https://onco.cc/key-papers/paper-rugo-pd-l1-assay-comparison-impassion130-jnci-2021/) - roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/) - ideas: [Harmonise PD-L1 testing for triple-negative breast cancer around one scored assay, with external quality assurance](https://onco.cc/ideas/idea-tnbc-pd-l1-assay-harmonisation/), [Standing reflex biomarker panels per tumour type, run without an oncologist's order](https://onco.cc/ideas/idea-acc-reflex-biomarker-panels-by-tumour/), [Turn the map of immune cells inside a tumour into a standardised test](https://onco.cc/ideas/idea-bio2-spatial-signature-cdx/) - technologies: [Companion diagnostics](https://onco.cc/technologies/companion-diagnostic/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/) - bottlenecks: [Biomarkers are not validated or standardised](https://onco.cc/bottlenecks/b-biomarker-validation/), [No one can predict who responds to immunotherapy](https://onco.cc/bottlenecks/b-immunotherapy-response/) - pathways: [Cold tumours: immune deserts and exclusion](https://onco.cc/pathways/immune-desert-exclusion/) - biomarkers: [PD-L1 CPS (combined positive score)](https://onco.cc/biomarkers/pd-l1-cps/) --- JSON: https://onco.cc/api/v1/entities/cps.json