The TNBC-DX genomic test effectively predicts pCR to neoadjuvant TCb ± pembrolizumab in TNBC. Notably, the TNBC-DX pCR-high group identifies patients with high sTILs who have a pCR rate exceeding 90% when treated with TCb+P. This study confirms that gene expression and sTILs provide distinct and potentially complementary information for pCR prediction in TNBC.