TNF and neoplasm: There are several defined causes of immunotherapy resistance, including low tumor mutational burden [2], impaired antigen presentation by the major histocompatibility complex (MHC) proteins [3], loss of interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) pathway genes [4,5], as well as the development of immunosuppressive tumor microenvironment (TME) [6,7].