This lack of response may be due to primary resistance conferred by mutations and dysregulation of cell signaling pathways in tumor cells, resulting in poor T cell recruitment and T cell dysfunction.1,39 For example, a study in highly aggressive HCC determined that low T cell numbers may be associated with deletions in the MAX/TP53 genes, which in turn resulted in the downregulation of TP53-related chemokines that are pivotal in T cell recruitment.74,75. The gene discussed is TP53; the disease is hepatocellular carcinoma.