If you have advanced kidney cancer, also known as metastatic renal cell carcinoma, your doctor may suggest you try immunotherapy. It helps some people with the disease live longer.
Though there are different types of immunotherapy, they all work in the same way: They get your body’s immune system to fight cancer cells. What you can expect from treatment, though, depends on which type of drug you get:
- Checkpoint inhibitors
- PD-1 inhibitor: Nivolumab ( Opdivo) and Pembrolizumab (Keytruda)
- CTLA-4 inhibitor: Ipilimumab (Yervoy)
- Cytokines:
- Interleukin-2: aldesleukin (Proleukin)
- Interferon-alfa [Intron A]
Checkpoint Inhibitors: Key Facts
These new and promising drugs work on a basic premise: Cancer uses specific substances on its cells to “hide” from your immune system. Checkpoint inhibitors block those substances, so your body can recognize the disease and launch a better attack.
Nivolumab ( Opdivo) is one of these drugs that works for metastatic kidney cancer. (It is not for the early stages of the disease.) If your doctor recommends this drug for you, you can expect:
- An infusion of the drug through a tube into your vein (an IV), which lasts about an hour
- Treatment every 2 weeks
- Side effects such as lung problems (coughing, shortness of breath), liver and kidney problems, changes in eyesight, and severe muscle or joint pain
- Blood tests to check for side effects
Ipilimumab (Yervoy) is used in combination with nivolumab via infusion to treat advanced renal cancer. Taking ipilimumab can compromise your immune system and make you susceptible to other illnesses
Scientists are testing other drugs in this category in large research studies to see how well they work.
Interleuken-2 (IL-2): Pros and Cons
IL-2 is a type of immunotherapy drug called a cytokine. It’s a protein that helps your immune system fight cancer. A high dose of IL-2 can work well for a long time, but it can also cause serious side effects:
- Fluid in the lungs
- Trouble breathing
- Heart attacks
- Bleeding in your intestines
- High fever and chills
- Fast heartbeat
Other things to know about high-dose IL-2 immunotherapy: You’ll only get it if your doctor thinks you’re healthy enough to handle the side effects. You take it as an IV infusion, and only at a hospital that has experience giving people high-dose IL-2.
Key Facts: Interferon-alpha
This type of immunotherapy is also a cytokine. It works by affecting how cancer cells divide, and it can slow the growth of renal cell cancer. Side effects are much less severe than IL-2. On the other hand, it doesn’t work as well -- at least not by itself. That’s why doctors usually prescribe it with another drug, bevacizumab (Avastin). For metastatic renal cell carcinoma, bevacizumab is given every 2 weeks through an IV infusion. Interferon-alpha is usually given as an injection three times a week.
Common side effects include:
- Fever
- Chills
- Muscle aches
- Fatigue
- Nausea
In the Pipeline
Researchers are studying two other types of immunotherapy drugs for advanced kidney cancer: vaccines and stem cell transplants.
Vaccines: You may think of them as shots that prevent illness, but doctors can also use them as immunotherapy treatments. They work by boosting your immune system’s ability to fight cancer.
Stem cell transplants: What if you could use a healthy person’s stem cells -- very early forms of immune cells -- to boost your body’s own defenses? Could that help your body fight cancer? Studies are underway to find out.
