The data from five clinical trials of anti-PD-1 monotherapy in Asia showed the overall response rate was only 18.0% and median PFS was 3–5 months.8 Compared with cutaneous melanoma, AM samples display a significantly severe immunosuppressive state, including depletion of cytotoxic CD8+ T cells, enrichment of Treg cells, and exhausted CD8+ T cells.4 Anti-PD-1 monotherapy demonstrates limited efficacy in AM, and combination therapy of ICIs has also shown similarly modest results. This evidence concerns the gene CD8A and cutaneous melanoma.