In a larger recent study including 60 selected patients with tumors of high mutational load (NSCLC, melanoma, and bladder carcinoma), a combination of PD-1 blockade with individual multi-SLP vaccines showed an excellent safety profile, and induced the development of CD8+ and CD4+ neoantigen-specific effector T cells (with CD107a cell surface expression in both T cell types) and epitope spreading [139]. The gene discussed is CD4; the disease is urinary bladder carcinoma.