Table 2.

Advantages and disadvantages of chemotherapy vs. active immunotherapy

	Immunotherapy
Advantages	Minimal toxicity*
	Indirect, immune-mediated antitumor effect.
	May work best in patients with minimal tumor burden.
	May be effective after completion of treatment.
Disadvantages	Delayed effect; may take months.
	Unlikely to relieve symptoms.
	No intermediate markers of benefit.
	Response assessment unclear (irRC in development).
	Chemotherapy
Advantages	Improved symptoms.
	Direct cytotoxic effect.
	Potential short-term benefit.
	Reliable response criteria (PFS, RECIST).
Disadvantages	Toxicity.
	Drug resistance may develop.
	Tumor growth may resume when therapy is discontinued.

^*Immune-related toxicity can be seen with immune-checkpoint inhibitors like anti-CTLA4 monoclonal antibodies, however therapeutic cancer vaccines have minimal toxicity.