This may be because anti-CTLA-4 therapy (a) increases the immune recognition of tumor cells, leading to tumor cell death and the release of neoantigens, which may contain mutation sites; (b) alters the tumor microenvironment, increases the inflammatory state of the tumor, and promotes the accumulation of mutations; (c) affects the biological properties of tumor cells, for example, by altering DNA repair mechanisms or cell cycle regulation, increasing mutation rate[75]. This evidence concerns the gene CTLA4 and neoplasm.