CD274 and small cell lung carcinoma: Since PD-L1 is associated with a poorer cancer prognosis in various types of cancer (gastric cancer, small cell lung cancer, pancreatic cancer, breast cancer) [83,84,85,86], for those patients in the lowest PD-L1 concentration quintile, vitamin D supplementation seemed to have a detrimental effect by upregulating serum PD-L1 levels; however, for those in the highest quintile, vitamin D was beneficial and downregulated serum PD-L1 levels [55,87].