Topically administered TLR7 agonists such as imiquimod (Aldara, Graceway Pharmaceuticals) have proven effective for the treatment of dermatological malignancy, and more recently have demonstrated encouraging results in a phase II study involving topical imiquimod in combination with IR for the treatment of cutaneous metastases in patients with breast cancer.30 In these settings, the TLR7 agonist can be applied directly to the tumor cells, and may therefore directly affect the tumor microenvironment ultimately leading to activation of tumor antigen-specific CD8+ T cells. The gene discussed is CD8A; the disease is breast carcinoma.