Higher levels of PD-L1+ lEVs in the blood correlated with improved response to immunotherapy, surpassing the predictive value of tissue PD-L1 expression, particularly in patients with low or absent tissue PD-L1 expression, highlighting PD-L1+ lEVs as a promising predictive marker for NSCLC immunotherapy. Here, CD274 is linked to non-small cell lung carcinoma.