The mechanisms of the adverse effects of immune checkpoints inhibitors are (1) release of cytolytic molecules (e.g., tumor necrosis factor-α, granzyme B, interferon-γ) that kill tumor cell and promote autoimmune lymphocytic myocarditis, (2) the PD-L1 and CTLA-4 are also expressed in heart and tumors and can share antigens that recognize by the same T-cell clones. This evidence concerns the gene TNF and neoplasm.