Given these data, the efficacy of DR-18 and anti–CTLA-4 combined therapy in the models tested, including Renca, a relatively ICI-resistant model, and prior findings on DR-18 efficacy in the MHC-I–deficient setting (12), a clinical trial exploring the safety and efficacy of DR-18 + anti–CTLA-4 in ICI-resistant/refractory RCC should be considered, potentially exploring changes in IL-18BP levels in tumor and/or plasma to select patients. This evidence concerns the gene CTLA4 and neoplasm.