When your renal cell carcinoma has spread beyond your kidneys, typical treatments for kidney cancer, like surgery, might not be an option. In these cases, doctors often turn to medicines that can seek out and destroy cancer cells wherever they are. Today, they often prescribe drugs called immunotherapies, which make your own immune system better able to fight cancer.
What Is Immunotherapy?
Your immune system finds and destroys cells and molecules that don’t belong in your body. But because cancer cells started out as your own healthy cells, your body’s defenses don’t always recognize them as dangers. Many tumors also make substances that help them hide from the immune system.
The goals of immunotherapy are to help your immune system to recognize cancer cells as threats, boost its response to these cells, and stop tumors from hiding.
Immunotherapy may not be the first treatment your doctor suggests. Although the drugs can work well in some cases, they can also cause severe side effects, so many doctors only prescribe them for relatively healthy people without other major medical conditions or those who’ve tried other drugs first.
This drug is a manmade version of a protein your body makes called interleukin-2 (IL-2). It turns on some of the cells in your immune system. The drug helps about 5% to 7% of people with renal cell carcinoma, but in those people, the drug can make the disease disappear for a long time.
High doses of IL-2, which you get in the hospital, offer the best chance of shrinking a tumor, but can also cause especially bad side effects. Only some treatment centers offer IL-2, and they may reserve it for certain types of people because of those side effects.
Interferon-alfa (Intron A)
This immunotherapy prevents cancer cells from growing and makes them more vulnerable to attack by the immune system. It has fewer side effects than aldesleukin, but it usually doesn’t work well on its own. So when it is used, it is often prescribed with other cancer drugs. Interferon-alfa has been mostly replaced by checkpoint inhibitor immunotherapy and molecularly targeted agents.
Nivolumab (Opdivo) and Ipilimumab (Yervoy)
This type of immunotherapy targets the substances, called checkpoints, that cancer cells use to evade the immune system. By blocking, or inhibiting, these checkpoints, the drugs make tumors more vulnerable to attack from your body’s defenses.
Nivolumab (Opdivo) was approved by the FDA in 2015 to treat kidney cancer in people who’ve tried other treatments that haven’t worked. In 2018 the combination of nivolumab and ipilimumab (Yervoy) was approved for treatment of previously untreated advanced kidney cancer.
In the Pipeline
Scientists are working to develop more immunotherapy medicines to treat renal cell carcinoma and other cancers. Some of them include:
- Cancer vaccines, which coax the immune system to recognize unique molecules on cancer cells and to attack anything that has these markers.
- Adoptive cell therapies, which involve taking immune cells from a person with cancer and altering them with cutting-edge genetics or chemicals to make them more active against cancer.
- Monoclonal antibodies, which like vaccines, recognize molecules on the surfaces of cancer cells. Attaching antibodies to other drugs can ensure that the drugs move to where tumors are located.