CTLA4 and neoplasm: Markers of T cell exhaustion include the increased surface expression of inhibitory receptors such as programmed death-1 (PD-1), cytotoxic T lymphocyte antigen-4 (CTLA-4), lymphocyte activation gene-3 (LAG-3), T cell immunoglobulin and mucin domain 3 (TIM-3), and T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain (TIGIT), which by binding to their ligands on antigen presenting cells or tumor cells inhibit T cell activation [7].