In a phase II study of ipilimumab monotherapy in 27 patients with advanced pancreatic ductal adenocarcinoma (PDAC), one patient had an objective response after initial pseudoprogression however there were no responses in the other 26 patients [33] Similarly, the anti-PD-L1 antibody BMS-936559 yielded 0% ORR in 14 patients with advanced PDAC in a multi-tumor type phase I study [34] Postulated reasons for such dramatic failures include low tumor mutational burden [35] and particularly dense desmoplastic stroma within the TME, impervious to adequate mobilization of immune cells [36]. This evidence concerns the gene CD274 and neoplasm.