CTLA4 and neoplasm: To overcome the lethality of pancreatic cancer, the unmet medical needs include (1) detection and diagnosis of early stages of the tumor, (2) elucidation of how this tumor adapts the escape mechanism(s) from immune surveillance and (3) further study of the mechanism that is exploited therapeutically in combination with immune checkpoint inhibitors, such as PD1, PDL1 and CTLA4.