The prognostic and predictive value of PD-L1 level and TMB in nccRCC is unclear, although higher PD-L1 level has been shown to correlate with poorer survival in several studies in the metastatic RCC space (inclusive of both clear cell and non-clear cell RCC) [84].Within the clear cell RCC context, recent data have highlighted the utility of metabolic profiling in predicting clinical outcomes including prognosis and response to therapies through a combination of metabolomics, lipidomics and transcriptomics. The gene discussed is CD274; the disease is renal cell adenocarcinoma.