Monoclonal antibodies targeting immune cell expressed cytotoxic T lymphocyte-associated protein 4 (CTLA-4) and programmed-death 1 (PD-1) along with TME expressed programmed death-ligand 1 (PD-L1) have led to approved treatment options for solid tumors such as melanoma, non-small cell lung cancer (NSCLC), and urothelial carcinoma (1). This evidence concerns the gene CTLA4 and urothelial carcinoma.