Subsequently, adaptive immune resistance depicted by total PD-L1 positive (immune stromal and tumor cells) was significantly enhanced in P+R (mean on- = 66.1, p = 0.0001; mean post- = 35.3, p = 0.0149), S (mean on- =72.6, p < .0001; mean post- =56.4, p = 0.0021) and S+R (mean on- = 62.5, p < .0001; mean post- = 71.0, p = 0.0015), compared to P (mean on- = 2.9; mean post- = 6.3). The gene discussed is CD274; the disease is neoplasm.