To date, no studies have elucidated whether ZFAS1 modulates tumor microenvironmental dynamics—such as PD-L1 expression or T-cell infiltration—or orchestrates epigenetic reprogramming (e.g. DNA methylation, chromatin accessibility) to confer resistance to PD-1/PD-L1 inhibitors [[92], [93], [94]]. This evidence concerns the gene ZFAS1 and neoplasm.