Patients with high PD-L1 expression on ≥50% of tumor cells clearly respond to first line therapy with pembrolizumab, but still some patients with lower or even negative expression of PD-L1 obtain response and benefit of extending progression free survival and overall survival in second line of ICI treatment [4,5,6,7,8,9,10,11,12]. This evidence concerns the gene CD274 and neoplasm.