CTLA4 and neoplasm: In fact, tumors often have the means to evade detection and destruction by immune cells at almost every conceivable immune mechanistic level by recruiting immunosuppressive cells, producing immunosuppressive cytokines, developing defects in tumor antigen presentation to T-cells or by expressing negative costimulatory molecules also called T-cell checkpoint regulators, such as the cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) 4-5.