These results were similar to the finding of the recent PEMBROSARC (Combination of MK3475 and Metronomic Cyclophosphamide in Patients With Advanced Sarcomas: Multicentre Phase II Trial) trial testing intratumoral TLR4 injection with pembrolizumab in STS, which also saw poor systemic efficacy but did not include radiotherapy.25 Given the outstanding local control seen combining radiotherapy with IT GLA-SE, combination studies with systemic therapies are warranted. This evidence concerns the gene TLR4 and telomere syndrome.