CTLA4 and cancer: As previously mentioned, the activity of programmed cell death 1 receptor (PD-1)/programmed cell death ligand 1 (PD-L1)- and cytotoxic T-lymphocyte-associated protein 4 (CTLA4)-blocking agents against PDAC is limited and the activity of novel combinations of immunotherapeutic agents reported so far has been at best disappointingly low in patients with microsatellite stable PDAC.55,56 The outcome of autophagy modulation to treat cancer is the result of a complex combination of the effect of autophagy on tumour cells and cells of the microenvironment, which includes immune cells.