In a separate study involving the use of nivolumab (anti-PD-1 mAb) only revealed a similar increase in sPD-L1 levels at first tumor evaluation which was associated with poor response (ORR 17% versus 68%, p=0.005), clinical benefit (10% versus 47%, p=0.049), shorter median PFS (1.8 months vs. 6.5 months, p = 0.008), and shorter median OS (5.4 months vs. NR, p = 0.028) (147). This evidence concerns the gene SPDL1 and neoplasm.