There is an increasing interest in immune checkpoint blockade (ICB) therapy, especially in the USA and most of Europe, as the anti-PD1 (aPD1) and anti-PD-L1 (aPD-L1) treatments have gradually become part of the standard for patients with locally advanced or metastatic urothelial cancer who relapse after CIS-based chemotherapy or are considered CIS ineligible, but the objective response rate is only 20%13. The gene discussed is CD274; the disease is in situ carcinoma.