Because a reduced expression of ST3GAL5 creates an immunosuppressive tumor microenvironment in bladder cancer patients, with key immune checkpoint genes (CTLA-4, LAG3, TIGIT, PD-1, PD-L1, CD80, CD86 and GZMB) being significantly upregulated compared to high-ST3GAL5 patients, this potentially enhances their susceptibility to immune checkpoint blockade therapy [41]. This evidence concerns the gene ST3GAL5 and urinary bladder carcinoma.