Thank you. The previous tumor that was removed showed positive TPS 6-10% and a TMB that is considered high at 52.6. Supposedly these qualities of the tumor make it a good candidate for the keytruda or immunotherapy. Yes the NEO in front of immuno means they start the drug before they take the tumor out. The believe is if the tumor is there, then the drug has something to work against and if it shrinks they know it is working. If they cut it out first, then they would still do the immunotherapy, but would do the full year, but not really know immediately if it was working or not. I guess my fear is it spreads while waiting after 6 weeks or so to see if it’s working. I have a very fast growing nodular melanoma. It came up between visits to the dermatologist, and by the time they got to it, it already spread to my lymph node. My doctor says there is a 50 percent chance it will grow while doing the treatment but still feels it’s the best thing to do.