The “obesity paradox” was mostly noted with ICI treatment in metastatic and non-metastatic colorectal cancer and renal cell carcinoma [245,247], as it was hypothesized that fatty liver, usually found in obese patients, would delay the clearance of ICI by altering its metabolism in the liver [242,248], along with the aforementioned increased PDL-1 expression and chronic inflammatory status. The gene discussed is CD274; the disease is obesity due to melanocortin 4 receptor deficiency.