Furthermore, exposure to broad-spectrum combination antibiotics (fluoroquinolones, ß-lactam+/- or macrolides) during anti-PD1/PD-L1 treatment has been shown to significantly decrease progression-free survival (PFS) and OS of patients with advanced non-small cell lung, renal cell carcinoma, and urothelial carcinoma, suggesting that the overall diversity of the microbiota and the presence of specific clades determines the responsiveness to immunotherapy (104). This evidence concerns the gene CD274 and hereditary clear cell renal cell carcinoma.