CTLA4 and neoplasm: Besides, tumor mutation burden (TMB) is another useful biomarker, and patients with TMB≥10/Mb have higher ORR to anti–PD-1+ anti-CTLA4 antibodies compared with chemotherapy (7).Thus, the Food and Drug Administration (FDA) has approved the use of pembrolizumab and nivolumab+ipilimumab in the first-line treatment of NSCLC patients with PD-L1 expression or high TMB However, the stratification of patients still needs further presicion.