In vulvar cancer, metastatic involvement of TDLN was accompanied by an inflamed microenvironment with immunosuppressive features, marked by hampered activation of migratory DCs, terminal CD8+ effector-memory T-cell differentiation, high regulatory T-cell rates, T-cell activation, and expression of CTLA-4 and PD-1 immune checkpoints [113]. Here, CTLA4 is linked to vulva cancer.