The following large phase II KEYNOTE-086 study did not demonstrate as impressive ORR-in 170 patients with a PD-L1-unselected pretreated tumor the ORR was only 5.3 In the same study, 84 patients who were treatment-naïve on the trial, the ORR was 21.4% suggesting that ICIs have greater efficacy in the first-line metastatic setting [56]. This evidence concerns the gene CD274 and neoplasm.