“…Ultraviolet exposure, with subsequent DNA damage that leads to a high tumor mutational burden (TMB), as well as a state of immunosuppression, is the main risk factors for cSCC development and interestingly, both factors correlate with superior response to immunotherapy [ 116 , 256 ]. In the recent decade, multiple trials confirmed the efficacy of ICI in various stages of the disease [ 117 , 118 , 124 , 257 , 258 , 259 ]. In most published studies, tumor response and survival subgroup analyses were mainly based on clinical characteristics, along with well-established biomarkers, such as TMB and PD-L1 status.…”