Additionally, there is evidence that the ratio of CTLs to malignant cells is higher in sarcomatoid MPM.24 Furthermore, by examining paired biopsies, Pasello and coworkers detected that the CD8+ cell proportion increased following administration of platinum plus pemetrexed.25 Finally, our own group has recently demonstrated via multiregional sequencing that CTL infiltration can be influenced by the tumor’s clonal architecture.26 This evidence concerns the gene CD8A and neoplasm.