It is worth noting that some AEs such as fatigue, hypertension, and diarrhea, are known class effects of VEGF-targeted TKIs,25-27 Some others are often difficult to relate to any of the 2 classes of agents.28-30 Our results show that costs related to treatment-related hypertension and increased ALT and AST and diarrhea in the pembrolizumab plus axitinib arm drive the cost difference between this treatment arm and either of the nivolumab-based combinations. The gene discussed is VEGFA; the disease is Hypertension.