More importantly, a survival benefit was observed in ES-SCLC patients with a low Treg/Teff ratio, as longer OS was observed in those with high percentages of CD8<sup>+</sup> Teffs and low FOXP3<sup>+</sup>CTLA-4<sup>+</sup> Tregs (<i>p</i> = 0.014) compared with those bearing low CD8<sup>+</sup> Teffs and high FOXP3<sup>+</sup>CTLA-4<sup>+</sup> Tregs. This evidence concerns the gene CTLA4 and small cell lung carcinoma.