Currently, only pembrolizumab can be considered as adjuvant therapy for intermediate- or high-risk operable RCC [I, C], while the metastatic disease is managed with tyrosine-kinase inhibitors (TKIs) or TKIs in combination with a PD-L1/CTLA-4 blockade [72]. The gene discussed is CTLA4; the disease is renal cell adenocarcinoma.