CTLA4 and cancer: For gynecologic cancers, we included terms such as "gynecologic cancer," "ovarian cancer," "cervical cancer," "endometrial cancer," "uterine cancer," "vulvar cancer," and "vaginal cancer." Immunotherapy-related terms encompassed "immunotherapy," "immune checkpoint inhibitor," "PD-1 inhibitor," "PD-L1 inhibitor," "CTLA-4 inhibitor," "CAR-T cell therapy," "cancer vaccine," and "adoptive cell therapy." We also included general terms like "randomized controlled trial" and "clinical trials" to focus on high-quality clinical research.