However, the lack of evaluation of the status of inflammatory cytokines (such as interleukins and TNF-α), anti-drug antibodies against DS-8201, or specific flow cytometry analysis of lymphocyte subtypes during the March 6 visit, when the patient presented symptoms of adrenal insufficiency, makes it challenging to discriminate whether the observed elevation in lymphocytes was attributed to the recent infection on February 23 or related to an irAE induced by DS-8201. The gene discussed is TNF; the disease is Adrenal insufficiency.