CTLA4 and neoplasm: The proportion of immune cell infiltration in the tumor microenvironment (TME)affects cancer patient survival and the immunotherapy response[10, 11].The expression levels of immune checkpoint inhibitors(ICIs) like cytotoxic T lymphocyte-associated protein 4 (CTLA4) and programmedcell death protein 1 (PD1)/ programmed cell death ligand 1 (PD-L1) are usuallysignificantly increased in hypoxic malignant tumors, and ICIs are moreeffective for a small proportion of LC patients[12].However, there are currently no tools available forforecasting the efficacy of immunotherapy in LUAD individuals.