A number of therapeutic approaches are being studied to harness the immune system and control malignancy. These approaches include cytokines, T cells (checkpoint inhibitors, agonism of costimulatory receptors), manipulation of T cells, oncolytic viruses, therapies directed at other cell types, and vaccines.

Lenalidomide and pomalidomide are immunomodulatory agents that have prolonged survival in multiple myeloma. These agents mediate their antitumor effects largely via the cereblon-mediated destruction of Ikaros family proteins that inhibit IL-2 secretion.

Interferon (IFN) alpha-2b promotes Th1-mediated effector cell responses such as IL-12 secretion via STAT-1 and STAT-2-mediated downstream signaling events. IFN-alpha is used as adjuvant treatment of high-risk melanoma, although its long-term impact on overall survival is controversial.

Bacillus Calmette-Guerin (BCG), derived from attenuated mycobacterium bovis, induces a robust inflammatory response when injected in the bladder and is used for the treatment of superficial bladder cancer.

Based upon prolonged overall survival in phase III trials and durable remissions in phase II studies, antibodies inhibiting PD-1 (pembrolizumab, nivolumab) and PD-L1 (atezolizumab, avelumab, durvalumab) have been developed and are approved for a number of clinical indications gun cancer like NSCLC, Melanoma, Head and neck squamous cell carcinoma, Urothelial carcinoma, RCC, Hodgkin lymphoma or for Microsatellite instability high colorectal carcinoma and other adult and pediatric solid tumors.

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