In addition to differences in the targeted immune checkpoints, a crucial difference affecting the success of immunotherapies for other tumors (22–24, 78)⁠ and the modest results of immunotherapy in ACC, such as less than 15% of patients with ACC benefiting from PD-1 or PD-L1 inhibition (30–33)⁠, seems to be the immunosuppressive and anti-inflammatory effects of intratumoral glucocorticoids (12)⁠. The gene discussed is CD274; the disease is adrenal cortex carcinoma.