TENM4 and melanoma: Nevertheless, considering reports of adoptive cell therapy for melanoma which targeted a visceral metastasis, and which also cross-reacted with a central nervous system antigen, causing significant toxicity, the safety issues potentially related to anti-TENM4 vaccinations need to be deeply investigated in in vivo systems, as do the vaccine’s immunogenicity and efficacy, which could be limited by the host immune tolerance against the self-antigen.