In clinically advanced disease, targeted therapies such as BRAF and MEK inhibitors are given for tumors that carry activating mutations in BRAF. More recently, monoclonal antibodies against cytotoxic T lymphocyte-associated-4 (CTLA-4), programmed death ligand-1 (PD-L1), and programmed death-1 (PD-1) have become widely used.2 The 2 PD-1 inhibitors, nivolumab and pembrolizumab, that have an indication for advanced melanoma from the US Food and Drug Administration (FDA) were both approved without companion diagnostics (CDx) to assess likely tumor responsiveness before initiation of ICPI. Here, CD274 is linked to neoplasm.