When MM spheroids were incubated with PBMCs from healthy donors, cell viability was comparable to that found with patients’ PBMCs while nivolumab addition induced a dramatic cell mortality which was reduced in the presence of circulating RES EVs and even more if they were from the non-responder, confirming that the circulating EVs might be directly correlated with the resistance to anti-PD1. The gene discussed is PDCD1; the disease is Miyoshi myopathy.