In addition, studies have also suggested negative impacts on efficacy of checkpoint inhibitors as well as survival in patients with LC that have tumors with increased CD4+ T cells expressing T-regulatory markers (FOXP3, CD25), resulting in immunosuppressive state suggested to hinder the recruitment and effector functions of CD8+ T cells39,40. This evidence concerns the gene FOXP3 and laryngotracheoesophageal cleft.