CTLA4 and cancer: Preclinical studies have postulated that inflammation induced by RFA may cause cancer progression via immunosuppression, while others demonstrate that ablation enhances host adaptive immunity.34,35 Although no combination of percutaneous ablation and immunotherapy has been currently endorsed, a small feasibility study in advanced disease patients who failed Sorafenib therapy, tested anti-CTLA4 Tremelimumab with RFA and cryoablation.36 With a median follow-up of about 3 years, the overall medial survival was 9.2 months for RFA and 15 months for cryoablation.