CTLA4 and cancer: When ICBs like CTLA4 and PD1 are used to treat some forms of cancer, tumors with high TMB have superior clinical results (Lu and Robbins, 2016; Ye et al., 2020; Graf et al., 2022; Shi et al., 2022) Cancer-associated antigens, including neoantigens derived from genetic mutations, are presented to CD8+ T cells through the major histocompatibility complex (MHC) on dendritic cells (DCs), and professional antigen-presenting cells (APCs).