CTLA4 and Miyoshi myopathy: The present study aimed to test the hypothesis that treatment with LOAd703, a TMZ-CD40L/4-1BBL-expressing gene engineering vector, reprograms the immune landscape in ICI refractory MM patients to restore ICI responsiveness.<h4>Methods</h4>LOKON003 a multi-center, single-armed phase I/II clinical trial recruited 24 patients with confirmed stage IV cutaneous MM (n = 23) and mucosal MM (n = 1) who had progressed on one, or several, treatments with anti-PD-1 inhibitors with or without supplementary anti-CTLA-4 inhibitor or experimental immunotherapy treatment.