Although PD-L1 expression as a biomarker in predicting the efficacy of ICIs has been extensively studied in various types of cancers,27–29 contradictory results have indicated that PD-L1 expression remains an imperfect predictor, as some studies established a positive correlation between PD-L1 and ICI response, while others detected no association.30 31 Our data found that the efficacy of nivolumab in combination with gemcitabine and cisplatin was independent of PD-L1 expression level. This evidence concerns the gene CD274 and cancer.