CD274 and neoplasm: Previous studies have reported PD-L1 overexpression, increased CTL (CD8 + cytotoxic T lymphocyte) densities and T-cell exhaustion in RELA ependymoma and hypothesized that tumor evasion and immunosuppression occur due to T-cell exhaustion secondary to the interaction between PD-1 and PD-L1 (Hwang et al. 2018; Witt et al. 2018; Nambirajan et al. 2019).