Checkpoint inhibitors targeting PD-1 or PD-L1, such as atezolizumab and nivolumab, have shown significant clinical efficacy in a subset of bladder cancer patients, particularly those characterized by a high tumor mutational burden (TMB), pre-existing tumor-infiltrating lymphocytes (TILs), and elevated IFN-γ–associated gene signatures (46). This evidence concerns the gene CD274 and neoplasm.