Immunological Features of Melanoma: Clinical Implications in the Era of New Therapies

The recent introduction of immune checkpoint inhibitors has been forcing the oncologists to face an unprecedented paradigm shift in cancer therapy. Unusual rationale and mechanisms of action, unexpected types of clinical response, and totally novel side effects, requested clinicians to rapidly gain familiarity with the immune system and its complex rules. A tight collaboration with researchers has become a common practice, to allow a bench-to bedside-and back approach and the fastest implementation of preclinical knowledge into clinical setting. This is particularly true for melanoma, one of the immunogenic—if not the most immunogenic—human malignancies, from which the vast majority of what we now know about cancer immunity has been learned. The present review is the authors’ view on the most recent and relevant information emerged in literature that should be taken into account when facing immunotherapy of melanoma patients. Having a general understanding of the pathways driving melanoma antigenicity and immune escape would help in applying these unique therapeutics under optimized conditions, tailoring treatment on individual patient immune profiles.