Obesity has the far reaching consequence on cancer pathogenesis and immune reactions. In particular, adiponectin (APN) produced by adipocytes played an important role in modulating obesity related malignancies. Via its interaction with corresponding receptors and their downstream signalling pathways, it regulates cells survival, apoptosis and cancer metastasis. Our review dissects the clinical evidence on how hypoadiponectinaemia associated with the increased risks of several cancers and the long-term prognosis and also addresses the controversies. APN also has its indirect effect on anti-cancer immune response which may influence the disease process. We also analyse the impact of APN on the immune system, the anti-tumour responses and the controversies surrounding this area. Targeting therapeutics on APN and its receptor axis represents a promising and novel anti-cancer treatment. Biological understanding of how APN and its interaction with its receptors may affect the immune reactivity. Careful strategizing the use of APN therapeutics in cancer treatment is important, as the APN receptor signalling on the immune cells can blunt anti-tumour response. Targeting APN or its receptors has an enormous implication for the treatment of cancers.

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