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Mechanisms of acquired resistance. (a) Immunoediting under the pressure applied by PD1/PDL1 blockade selectively preserves tumor cells that have superiority to escape antitumor immunity. (b) Compensatory inhibitory signaling is upregulated in the course of therapy, making it difficult for PD1/PDL1 blockade to reinvigorate CD8+ T cells. (c) If tumor specific T cells fail to become memory T cells, therapy response will not persist and T cells will be re-exhausted.
