The CAR cell-mediated delivery of cytokines (IL-12, IL-7, IL-15, IL-18, and IL-23) [142–147] or other payloads (anti-PD-1 and/or anti-CTLA-4, anti-PD-L1) [148, 149] to the tumor has shown promise in preclinical studies, and some clinical trials have been initiated to further test the efficacy and safety of the fourth or next generation of CAR-T cells [150]. This evidence concerns the gene PDCD1 and neoplasm.