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Under a Creative Commons license open access Highlights • Human bladder tumors contain multiple clonally expanded cytotoxic CD4+ T cell states • Cytotoxic CD4+ T cells can kill autologous tumors in an MHC class II-dependent fashion • Autologous regulatory T cells can inhibit the activity of cytotoxic CD4+ T cells • A cytotoxic CD4+ gene signature predicts response to anti-PD-L1 in bladder cancer Summary Responses to anti-PD-1 immunotherapy occur but are infrequent in bladder cancer.
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