Given the strong preclinical rationale for combining VEGF inhibitors with immune checkpoint regulators, an increasing number of clinical trials are underway in several solid tumors including urothelial carcinoma [44, 45], metastatic renal cell carcinoma (mRCC) [46–48], and non-small cell lung cancer (NSCLC) [49–51], aiming to evaluate the anti-angiogenesis agents reinforce the benefit and durable responses afforded by anti- cytotoxic T-lymphocyte associated protein-4 (CTLA4) and the PD-1/PD-L1 agents. The gene discussed is CTLA4; the disease is urothelial carcinoma.