Evidence map›Paper›PMID 41786455›Full record

ArticleJournal for immunotherapy of cancer2026

Resistance to anti-PD-1 immunotherapy for stage III and IV melanoma: a global chart review study.

Elizabeth M Gaughan, Miso Kim, Ignacio Mendez, Aparna D Rao, Maria Wei, Alexandra So, Xiaochen Zhong, Carola Berking, Ruixuan Jiang, Tae Min Kim and 29 more

Abstract read
In one paragraph

Article in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

39 authors.

Elizabeth M GaughanUniversity of Virginia Cancer Center, Charlottesville, Virginia, USA.
Miso KimSeoul National University Hospital, Seoul, South Korea.
Ignacio MendezOXON Epidemiology, Madrid, Spain.ORCID http://orcid.org/0000-0001-9146-6807
Aparna D RaoPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-6394-0011
Maria WeiUniversity of California San Francisco, San Francisco, California, USA.
Alexandra SoUniversity of California San Francisco, San Francisco, California, USA.
Xiaochen ZhongUniversity of California San Francisco, San Francisco, California, USA.ORCID http://orcid.org/0009-0008-6015-9538
Carola BerkingDepartment of Dermatology, Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander- Universität Erlangen-Nürnberg, Erlangen, Germany.ORCID http://orcid.org/0000-0003-0229-8931
Ruixuan JiangMerck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc, Rahway, New Jersey, USA.
Tae Min KimSeoul National University Hospital, Seoul, South Korea.ORCID http://orcid.org/0000-0001-6145-4426
Stéphane DalleCentre Hospitalier Lyon-Sud, Pierre-Benite Cedex, France.
Caroline RobertInstitut Gustave-Roussy, Villejuif, France.ORCID http://orcid.org/0000-0002-9493-0238
Sarah DansonWeston Park Cancer Centre, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.ORCID http://orcid.org/0000-0002-3593-2890
Salma AlamMount Vernon Cancer Centre, Northwood, UK.
Julie CharlesCHU Grenoble, La Tronche, France.
Tessa DaviesVelindre University NHS Trust, Cardiff, UK.
Dirk DebusDepartment of Dermatology, Nuremberg Hospital, Paracelsus Medical University, Nuremberg, Germany.
Marcin DzienisGold Coast University Hospital, Southport, Queensland, Australia.
Ricky FrazerVelindre University NHS Trust, Cardiff, UK.
Christoffer GebhardtDepartment of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID http://orcid.org/0000-0001-7090-9584
Glenn GeidelDepartment of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID http://orcid.org/0009-0008-3999-5902
Jessica C HasselHeidelberg University, Medical Faculty Heidelberg, Department of Dermatology and National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and University Hospital Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0001-7575-6230
Inga HansenDepartment of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Markus Vincent HepptDepartment of Dermatology, Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander- Universität Erlangen-Nürnberg, Erlangen, Germany.ORCID http://orcid.org/0000-0003-4603-1825
Lina HildebrandtDepartment of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
James M IsaacsCleveland Clinic, Cleveland, Ohio, USA.
Koung Jin SuhSeoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Bhumsuk KeamSeoul National University Hospital, Seoul, South Korea.ORCID http://orcid.org/0000-0002-2974-675X
Yu Jung KimSeoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Thierry LesimpleCentre Eugène Marquis, Rennes-Cedex, France.
Philippe SaiagDepartment of General and Oncologic Dermatology, Ambroise Paré hospital, APHP, & EA 4340 "Biomarkers in cancerology and hemato-oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France.ORCID http://orcid.org/0000-0002-6500-3507
Alicia DelibesOXON Epidemiology, Madrid, Spain.
Rosemarie BarnettOXON Epidemiology, Madrid, Spain.ORCID http://orcid.org/0000-0002-2215-4970
Clemens KreplerMerck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc, Rahway, New Jersey, USA.
Kavita GandhiOXON Epidemiology, Madrid, Spain.ORCID http://orcid.org/0000-0003-2573-2630
Nawab QizilbashOXON Epidemiology, Madrid, Spain.
Irene M ShuiMerck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc, Rahway, New Jersey, USA.ORCID http://orcid.org/0000-0001-5737-9830
Xiang-Lin TanMerck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc, Rahway, New Jersey, USA xianglin.tan@merck.com.
Ryan J SullivanMassachusetts General Brigham Cancer Institute, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0001-5344-6645

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnti-programmed cell death protein 1 (PD-1) immunotherapy has revolutionized the treatment of stage III and IV melanoma. Real-world data on its resistance is needed to facilitate the development of combinatorial approaches to overcome anti-PD-1 resistance.

objectivesTo characterize anti-PD-1 resistance and assess whether progressive disease assigned by clinicians is concordant with scan data assessed by independent central reviewers (ICR).

methodsA retrospective chart review was conducted in adult patients with stage III/IV melanoma who initiated anti-PD-1 therapy from January 2018 until 12 months before the start of data collection at 22 sites across six countries. Primary resistance and late relapse in the adjuvant setting, and primary, secondary resistance, and late progression in the advanced setting were assigned using

resultsOf 981 eligible patients, 738 were included. In the adjuvant setting (n=240), 53 (22.1%) patients developed primary resistance and 60 (25.0%) experienced late relapse. In the advanced setting (n=498), 222 (44.6%), 50 (10.0%), and 64 (12.9%) patients developed primary, secondary resistance, and late progression. Type of resistance significantly differed by country, race, type of

conclusionsThis study showed that a substantial proportion of patients with melanoma receiving anti-PD-1 therapy in the adjuvant (47.1%) and advanced (67.5%) settings developed resistance or late relapse/progression, highlighting an unmet medical need. Real-world clinical practice provided a reliable assessment of progression. Factors associated with different types of resistance were identified. Further study is warranted to evaluate their impact on patient risk stratification. (Graphical abstract).

Indexed as

Drug Resistance, NeoplasmImmune Checkpoint InhibitorsImmunotherapyMelanomaProgrammed Cell Death 1 ReceptorAdultAgedFemaleHumansMaleMiddle AgedNeoplasm StagingRetrospective StudiesImmune Checkpoint InhibitorsPDCD1 protein, humanProgrammed Cell Death 1 ReceptorAdjuvantImmune Checkpoint InhibitorImmunotherapyMelanoma

Identifiers

PMID41786455
PMCPMC12970133

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.