In cases where the kidney cancer is advanced or has spread and surgery alone is not sufficient to control the disease, there are a number of treatment options available.
These drugs have all been specifically designed to target biological changes that occur in kidney tumours, and stop tumours from being able to grow. There are three types of targeted therapy, tyrosine kinase inhibitors, mTOR inhibitors, and monoclonal antibody therapy.
The Tyrosine Kinase Inhibitors (TKIs) inhibit the tyrosine kinase signaling pathway, thus blocking cell growth and division. TKIs used to treat kidney cancer are Sorafenib, Sunitinib, Pazopanib and Axitinib.
Bevacizumab is a monoclonal antibody used to treat advanced kidney cancer. It works by sticking to a protein called VEGF, which stops it working. This prevents the tumour being able to grow blood vessels, essentially cutting off its food supply.
A table of current immunotherapy trials in RCC is available here.
Chemotherapy is not normally used to treat kidney cancer as targeted therapies are more effective. However, chemotherapy might be an effective treatment for any secondary tumours that have been caused by the original kidney tumour spreading to other parts of the body. Additionally, several clinical trials are testing if combining chemotherapy with targeted therapies is more effective than targeted therapy alone.
Like chemotherapy, radiotherapy is not normally used to treat kidney cancer as it is not as effective as other treatments. However, radiotherapy is often used to treat kidney cancer that has spread to the brain.
A number of new treatments for kidney cancer are currently being tested and are only available as part of a clinical trial. These include:
- Vaccines e.g. IMA901
- New immunotherapies e.g. Nivolumab
- Non-myeloablative allogenic stem cell transplant
Publication date: December 2014
Review date: December 2017