Taking into account the inter- and intra-tumor variability of PD-L1, as well as the limitations in terms of sensitivity/specificity (PD-L1 can also be expressed in other inflammatory conditions), the heterogeneity of exosomes due to their origin from both tumor cells and immune system cells or other tissues, and the ability of tumors to use alternative pathways to avoid the immune system (tumor immune evasion), the need for a multi-marker approach is essential for more accurately assessing immune suppression and developing a more robust and predictive biomarker profile. This evidence concerns the gene CD274 and neoplasm.