Given the elevated risk of developing metastatic disease and requiring systemic immunotherapy later on, our study focused on investigating the variability in PD-L1 expression, as determined by the Combined Positive Score (CPS), particularly in the context of intravesical Bacillus Calmette–Guérin (BCG) in patients with high-risk non-muscle-invasive bladder cancer (NMIBC) [21]. Here, CD274 is linked to metastatic neoplasm.