These changes have all been noted in bladder cancer (Figs. 1, 2), which is characterized by a highly immunosuppressive microenvironment that includes increased expression of the inhibitory ligand PD-L1, the strong presence of MDSCs, TAMs, increased PGE2 production and aberrant metabolism of glycosaminoglycans such hyaluronic acid or hyaluronan. The gene discussed is CD274; the disease is urinary bladder carcinoma.