In an analogous scenario, the impact of PD-L1 expression is abated in patients with melanoma treated with PD-1 plus CTLA-4 blockade (Wolchok et al., 2017), and in a report of 17 patients with melanoma treated with combination immunotherapy, TMB did not correlate with response (Goodman et al., 2017). This evidence concerns the gene CTLA4 and melanoma.