Currently, there are no reliable biomarkers, such as tumor mutation burden (TMB), and programmed cell death-ligand 1 (PD-L1) expression, that can accurately predict clinical outcomes.6,7 The recent molecular understanding of SCLC has been translated into only modest clinical improvements, highlighting the urgent need for a better understanding of this recalcitrant malignancy. This evidence concerns the gene CD274 and neoplasm.