The exosome is a class of extracellular vesicles with particle size of 40–160 nm.[7] It has been reported that external stimuli, i.e., pH, temperature, and hypoxia, often accelerate the release of exosomes.[8] Tumor cell‐derived exosomes (TEX) play important roles in immune escape for the high expression of PD‐L1 on the surface and various miRNA contents, which could mediate immune evasion and regulate immune cell phenotypes.[9] Thus, TEX was supposed to negatively modulate the immune effect of mild PTT. This evidence concerns the gene CD274 and neoplasm.