In ccRCC patients with lung metastases, those with high densities of PD1 positive lymphocytes and PD-L1 and/or PD-L2 positive tumor cells in the metastatic lesions have a poorer prognosis, with a 3.1-fold increased risk of death after metastasectomy compared to negative patients [105]. The gene discussed is CD274; the disease is nonpapillary renal cell carcinoma.