Studies have found several factors that can affect the response to immunological checkpoint therapy including tumor antigens (e.g. neoantigens, tumor mutation burden, microsatellite instability) [44], immunosuppressive and inflammatory cells or proteins (e.g. TILs and tumor-associated immune cells, gene signatures, CTLA-4, IDO, PD-L1) [45], and host factors (single-nucleotide polymorphisms and microbiome) [46]. This evidence concerns the gene CTLA4 and neoplasm.