Beyond the lack of power in our study and the technical issues with PD-L1 immunostaining, we cannot exclude either that more complex biological factors could interfere with PD-L1 tumor expression, such as resident T-cell infiltration [32] and cancer-associated fibroblast inhibitory effect of T-cell mediated anti-tumor activity [33], while gut microbiome could also play a major role in NSCLC patients [34]. The gene discussed is CD274; the disease is cancer.