These changes create a local environment that is hostile to effective immune responses, thereby protecting the tumor from immune-mediated destruction.248,249 Additionally, the phenotypic plasticity of cancer cells within a heterogeneous tumor allows for the adoption of traits that further enhance immune evasion, such as upregulation of immune checkpoint molecules or downregulation of MHC molecules, which are critical for antigen presentation.248,250. The gene discussed is HLA-C; the disease is neoplasm.