Furthermore, sPD-L1 is thought to lower the efficacy of anti-PD-1/anti-PD-L1 therapies as it can bind anti-PD-L1, thus limiting the concentration of antibody at the tumor site, and it may bind to PD-1 thus reducing epitopes available for anti-PD-1 treatments17–19. This evidence concerns the gene SPDL1 and neoplasm.