CTLA4 and Merkel cell skin cancer: Successful reversal of this immune evasion by checkpoint inhibitors is now a clinical reality, with inhibitors of cytotoxic T lymphocyte-associated protein-4 (CTLA-4) as well as programed cell death protein-1 (PD-1) and programed death ligand-1 (PD-L1) delivering durable responses in a subset of patients with a range of cancer types including melanoma (2, 3), urothelial carcinoma (4), Hodgkin lymphoma (5), non-small cell lung carcinoma (6–8), Merkel cell carcinoma (9), and squamous cell carcinoma of the head and neck (10).