Primary resistance to immune checkpoint inhibitors in melanoma

SUMMARY

Immune checkpoint inhibitors have become the standard of care in previously untreated melanoma, reaching a median overall survival exceeding three years. While particularly successful in some, a significant portion of patients will never obtain treatment benefit. Over a decade of research has revealed a complex and dynamic interaction between a myriad of cancer-intrinsic and -extrinsic factors driving immune evasion, which emerge during tumour formation and shift early during treatment. In this review, we discuss primary resistance mechanisms to immune checkpoint inhibition in melanoma, and consider predictive biomarkers and their potential clinical implications.

(BELG J MED ONCOL 2024;18(3):75–81