Immune checkpoints like PD-L1 and CTLA-4 are overexpressed in tumor and immune cells, inhibiting T cell activation and proliferation, which hampers the anti-tumor response.53,54 Tumor cells can upregulate immune checkpoint molecules in response to a variety of circumstances, including oncogenic signaling pathways and the presence of inflammatory cytokines in the TME. This evidence concerns the gene CTLA4 and neoplasm.