CTLA4 and small cell lung carcinoma: One way to determine whether anti-CTLA4 is efficacious due to its immune modulatory effects is to examine whether it provides any tangible or meaningful clinical benefits (1) beyond the presumed anti-cancer (+/− immune modulatory) effects of anti-PD1/L1 (i.e., whether anti-CTLA4 + anti-PD1 is superior to anti-PD1 alone) and (2) compared with other purported anti-cancer treatments (e.g., whether anti-CTLA4 + anti-PD1 is superior to anti-PD1/L1 + chemotherapy for non-small-cell lung cancer/small cell lung cancer (NSCLC/SCLC), or anti-PD1/L1 + TKI for RCC) [76].