Although LPS inthe tumor microenvironment can stimulate innate immunity by activatingtoll-like receptor 4 (TLR4) and trigger cytokine-mediated tumor suppression,8 exposure in the bloodstream can lead to excessivelevels of systemic cytokines, which can cause severe fever and septicshock.9 LPS is also linked to molecularpathways that can trigger pyroptosis,10 apoptosis, and necroapoptosis,11 whichcan lead to immune cell death and immune tolerance. This evidence concerns the gene TLR4 and neoplasm.