To the Editor We read with great interest the comments by Donia and Prasad1 suggesting that for patients with tumors exhibiting positive staining (鈮�1%) for programmed cell death ligand 1 (PD-L1), nivolumab monotherapy offers maximal benefit while cautioning against the necessity of the combination therapy due to toxic effects and cost. However, we wish to address certain points and express our reservations regarding this stance.