Following systemic intravenous delivery, where pelareorep has demonstrated the ability to escape neutralizing antibodies found in patients, it binds to peripheral blood mononuclear cells (PBMCs), mainly natural killer cells and dendritic cells. The binding of pelareorep to PBMCs protects the virus from antibody neutralization and helps deliver the virus to the primary tumor and metastatic sites. In addition, the binding of pelareorep to PBMCs also promotes immune cell activation, facilitating an anti-cancer immune response.