Because cSCC is primarily derived from UV radiation, cSCCs have a high tumor mutation burden that can elicit a host anti-tumor immune response, as evidenced by the presence of CD8+ lymphocyte infiltration in all cases in our study.31, 32, 33 Patients with tumors that have high mutation burdens are also more likely to respond to immunotherapy with a checkpoint inhibitor, presumably because the tumors have greater neoantigen expression.31, 32, 33. Here, CD8A is linked to neoplasm.