Our data confirmed previous evidence that CART-cell therapy also induces epitope spreading.10 11 It has been reported that CD8 T-cell cytotoxic activity induced immunogeneic tumor-cell death (ITCD),31 32 with this phenomenon being partially dependent on Perf-dependent killing.32 This CART-mediated ITCD may explain the enhanced tumor-specific endogenous T-cell response observed with CART cell monotherapies. The gene discussed is CD8A; the disease is neoplasm.