Action on myeloid cell types and the generation of new T cell clones at priming, potentially including autoreactive ones, maybe a principal mechanism of PD-1 and CTLA-4 blockade with only secondary effects on CTL killing43,44: In basal and squamous cell carcinoma patients, anti-PD-1 does not lead to the activation of existing anti-tumor T cell clones but to tumor enrichment of new ones6. Here, CTLA4 is linked to neoplasm.