Mechanisms of resistance to anti-Pd-1 therapy in metastatic cutaneous melanoma

The appearance of modulators immune synapse in clinical practice has become a revolution in metastatic skin melanoma treatment. However, blockade PD-1 allows to achieve objective response in only 30–40 % of patients. Recently, many mechanisms of primary resistance of melanoma to immunotherapy studied, they related both to the characteristics of the tumor and the tumor microenvironment. The response to anti-PD-1 therapy usually is durable, but acquired resistance emerges in 25 % of patients, who had an objective response to this treatment. This review will describe the main mechanisms of resistance to anti-PD-1 therapy in metastatic skin melanoma and possible ways of their overcoming.