Another study found that MLN4924 can cause impaired NEDD8-dependent clearance of misfolded proteins in dMMR/MSI tumors (deficient DNA mismatch repair/ microsatellite instability tumors), and by combination with anti-PD1, potent synergistic activity was achieved and tumor immune microenvironment was tested to be altered since the number of cytotoxic T cells and conventional CD4+ T cells increased whereas regulatory T cells reduced (McGrail et al., 2020). This evidence concerns the gene NEDD8 and neoplasm.