CTLA4 and metastatic melanoma: In patients with metastatic melanoma, the combination of bevacizumab with anti-cytotoxic T-lymphocyte associated protein 4 (CTLA-4) monoclonal antibody increases the expression of E-selectin, ICAM-1, and VCAM-1, and enhances T cell recruitment in the tumor microenvironment and improves the clinical outcome (41).