So far, the addition of ipilimumab to nivolumab did not seem to improve the efficacy in terms of tumor downstaging or PTR (53% vs 69% and 38% vs 40%, respectively) while it did increase toxicity.32 In SNOW, clinical to pathological downstaging occurred in 9 out of 10 patients (90%), and a reduction in viable tumor >50% was observed in 50% of the patients regardless of PD-L1 expression, suggesting a potential additive and/or synergistic effect of sitravatinib and nivolumab. This evidence concerns the gene CD274 and neoplasm.