Home›Oncology› Melanoma Immunoediting Review Maps Elimination, Equilibrium, Escape and Drivers of Immunotherapy Resistance
Melanoma Immunoediting Review Maps Elimination, Equilibrium, Escape and Drivers of Immunotherapy ResistanceImmune System Changes Drive Melanoma Growth and Treatment Resistance
Frontiers in MedicinePublished September 19, 2026Study authors: Xiaojun Yan, Qian Zhang, Zeping Chen, Haiyan ZhouDOI ↗Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development
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Key Takeaway
Recognize immunoediting as a mechanistic framework, not yet a clinical decision tool.
This systematic review examines the tumor immunoediting process in melanoma, organizing existing knowledge around three sequential phases: elimination, equilibrium, and escape. The authors synthesize evidence that functional dysregulation of immune cell subsets, imbalance of cytokine networks, and alterations in the metabolic milieu collectively drive immunoediting. No pooled effect sizes, sample sizes, or follow-up data are reported, consistent with a synthesis of mechanistic and preclinical literature rather than primary clinical trial data.
The review's stated purpose is to provide a theoretical basis for optimizing melanoma immunotherapy and identifying novel therapeutic targets. It does not report clinical outcomes, comparators, or adverse events.
The authors acknowledge a key limitation: most existing studies have focused on individual phases or isolated factors, and a comprehensive understanding of the entire immunoediting process and its systematic associations with tumor heterogeneity and resistance to immunotherapy remains insufficient. Funding sources and conflicts of interest are not reported.
For clinicians, this review offers a conceptual framework for understanding why some melanomas evade immune control and checkpoint inhibition, but it does not provide practice-changing clinical data. The findings should be interpreted as hypothesis-generating and supportive of ongoing translational research, not as direct guidance for treatment selection.
How this fits prior evidence
This review extends prior coverage of melanoma immunotherapy resistance by framing it within the immunoediting model. Prior items noted that mitophagy may drive immune evasion and checkpoint inhibitor resistance in skin cancers, and that objective response rate correlates with overall survival in nivolumab-containing regimens. The current review broadens the mechanistic context to include immune cell dysregulation, cytokine imbalance, and metabolic alterations across elimination, equilibrium, and escape phases. It contrasts with clinical coverage of encorafenib plus binimetinib and ivermectin or fenbendazole by remaining preclinical and theoretical, and it does not address phytochemical candidates.
This review looks at the process of tumor immunoediting in melanoma. This process describes how the body's immune system interacts with cancer cells over time. It happens in three specific stages: elimination, equilibrium, and escape. During these stages, the immune system tries to fight the cancer, but the cancer eventually finds ways to survive.
Several factors drive these changes. These include the breakdown of specific immune cells, an imbalance in cytokine networks, and changes in the metabolic environment around the tumor. These factors together help the cancer evade the body's natural defenses.
Because most current research focuses on only one part of this process, a full understanding of how these factors lead to treatment resistance is still limited. This review aims to provide a theoretical foundation for finding new ways to improve melanoma immunotherapy and identifying new targets for treatment.
What this means for you:
Immune system changes and metabolic shifts help melanoma cells escape and resist treatment.
Common questions
What is tumor immunoediting in melanoma?
Tumor immunoediting is the process by which the immune system interacts with melanoma cells. It involves three sequential phases: elimination, equilibrium, and escape. These stages describe how the body attempts to fight the cancer and how the cancer eventually adapts to survive.
Why does melanoma become resistant to treatment?
Resistance is driven by the process of immunoediting. This process is fueled by the breakdown of immune cell subsets, an imbalance in cytokine networks, and changes in the metabolic environment. These factors collectively help the tumor evade the immune system.
How can this research help patients with melanoma?
By understanding the full process of immunoediting and the factors that drive it, researchers hope to find better ways to optimize immunotherapy. This knowledge helps identify new targets to help the immune system better fight the cancer.
Tumor immunoediting is a dynamic process of interaction between the host immune system and tumor cells and encompasses three sequential phases: elimination, equilibrium, and escape. It plays a central regulatory role in melanoma initiation, progression, and therapeutic response. Currently, increasing attention has been directed toward the complexity of the melanoma tumor microenvironment, in which functional dysregulation of immune cell subsets, imbalance of cytokine networks, and alterations in the metabolic milieu collectively drive the process of immunoediting. However, most existing studies have focused on individual phases or isolated factors, and a comprehensive understanding of the entire immunoediting process and its systematic associations with tumor heterogeneity and resistance to immunotherapy remains insufficient. This review summarizes recent advances in tumor immunoediting within the melanoma tumor microenvironment, with particular emphasis on the regulatory mechanisms through which individual components of the immune microenvironment influence different phases of immunoediting, providing a theoretical basis for optimizing melanoma immunotherapy and identifying novel therapeutic targets.
