TLR4 and Tumor Lysis Syndrome: In fact, a cohort of 20 TLS- patients from the PEMBROSARC study were treated with pembrolizumab, low-dose cyclophosphamide and intra-tumoral injection of the toll-like receptor 4 (TLR4) agonist G100, which would potentially enhance the immune response against a TLS-negative TME [153].