The expression of programmed death-ligand 1 (PD-L1) can be used as a clinical biomarker to determine the efficacy of immune checkpoint inhibitor treatment; however, there are many areas of uncertainty when it comes to PD-L1 testing. In this interview, recorded at the 2018 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference held in Denver, CO, Jacob Kettle, PharmD, BCOP, of the University of Missouri Health Care, Columbia, MO, discusses the challenges of using PD-L1 levels as a determining factor in offering treatment to cancer patients.