T cell and macrophage–expressed CYP11A1 may instead promote tumor growth by generating pregnenolone that acts via a nonglucocorticoid signaling pathway, such as by activation of pregnane X receptors (PXRs) (21), or further pregnenolone conversion to progesterone, androgens, or estrogens, all of which can have immunomodulatory actions (56) and direct growth-promoting actions on tumor cells (57). Here, CYP11A1 is linked to neoplasm.