Thus, it has been observed that, in subjects with metastatic melanoma treated with the cytotoxic T-lymphocyte antigen-4 (CTLA-4) pathway inhibitor and programmed cell death-1 protein (PD-1) pathway inhibitor, increasing T cells, the development of vitiligo could also potentially lead to better response and survival rates [42]. This evidence concerns the gene CTLA4 and metastatic melanoma.