Their presence and function are shaped by tumor necrosis factor (TNF)-α signaling and cyclooxygenase (COX)-2 activity, reinforcing a tumor-promoting cycle.3 CD4+ T cells orchestrate adaptive immune responses and can play both antitumor (Th1) and pro-tumor (Th2/Treg) roles depending on the surrounding cytokine environment. The gene discussed is TNF; the disease is neoplasm.