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Biologic therapy (also called immunotherapy) uses drugs to improve the way your body fights cancer. The therapy attempts to repair, stimulate, or enhance the immune system so that it can identify and fight the cancer cells more effectively. It may be used alone or in combination with other treatments.
Cytokines are reproduced proteins that activate the body's immune system. Examples of cytokines used to treat kidney cancer include interferon alfa and interleukin 2 ( IL-2, aldesleukin, or proleukin).
Interleukin 2 (IL-2) is given by injection under the skin or by IV for metastatic kidney cancer. Treatment may be given in cycles separated by a rest period. In some cases, IL-2 results in shrinking the tumor. In others, the tumor may disappear completely, though there is a chance of recurrence. IL-2 treatment is not appropriate for all people with metastatic kidney cancer because of the serious side effects.
Targeted therapies attempt to interfere with the growth of the tumor by blocking the formation of new blood vessels around the tumor. Though not a cure, these medications may shrink or slow the growth, and/or spread of tumors, and extend survival time.
Bevacizumab works by slowing the growth of new blood vessels. At times it may be combined with interferon alfa, which boosts specific components of the immune system.
The most common side effects when bevacizumab is used alone include:
The most common side effects when bevacizumab is used in combination with interferon alfa include:
Axitinib works by preventing the growth of new blood vessels to tumors through various pathways. The most common side effects include:
Everolimus reduces the blood supply and slows tumor growth. It may be used when other, similar types medications are no longer working. The most common side effects include:
Pazopanib works by preventing the growth of new blood vessels to tumors. The most common side effects include:
Sorafenib targets several different pathways of tumor growth. The most common side effects include:
Sunitinib attacks both blood vessel growth and other targets that stimulate cancer cell growth. The results show tumor shrinkage in one third of the patients treated. Side effects may include:
Temsirolimus works to inhibit cell growth. The most common side effects include:
If both kidneys are removed or no longer function, dialysis will be necessary. Dialysis mimics kidney function by filtering wastes and excess fluids from the blood. It is a permanent treatment if a kidney transplant cannot be done. There are 2 main types of dialysis:
Escudier B, Eisen T, Standler WM, et al. Sorafenid in advanced clear-cell renal cancer carcinoma. N Engl Med. 2007;356(2):125-134.
Kidney cancer. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/kidneycancer. Accessed January 3, 2017.
Kidney cancer (adult)—renal cell carcinoma. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003107-pdf.pdf. Accessed January 3, 2017.
Renal cell carcinoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114704/Renal-cell-carcinoma. Updated March 14, 2016. Accessed January 3, 2017.
Renal cell carcinoma. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/renal-cell-carcinoma. Updated November 2013. Accessed January 3, 2017.
Rini BI, Halabi S, Rosenberg JE. Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. J Clin Oncol. 2010;28(13):2137-2143.
Treatment options for renal cell cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq#section/_93. Updated December 23, 2016. Accessed January 3, 2017.
Last reviewed December 2016 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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