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Systemic Therapy Options for Kidney Cancer
When kidney cancer has spread to other areas or presents itself as high risk, Fox Chase doctors often use system-wide or systemic approaches for treatment. Your medical oncologist may recommend systemic therapy, such as targeted drug therapy or immunotherapy, for your personalized treatment plan, either as a standard of care or as part of a clinical trial.
Most kidney cancer patients are candidates for targeted therapy and immunotherapy. These therapies work differently and can be used separately or in conjunction to treat kidney cancer.
Systemic therapy may be given before or after surgery and may also be recommended to patients who are diagnosed after the cancer has spread to other parts of the body.
Targeted Drug Therapy
Targeted therapy drugs are used to help fight metastatic kidney cancer. This class of drugs is designed to control the cancer and reduce or prevent cancer-related symptoms. Some of these therapies target and block the signals that cause new blood vessels to form; others block the signals for more cancer cell growth. They often have more than one target.
The following are some common targeted drug therapies:
- Tyrosine kinase inhibitors: Bind onto the proteins inside cancer cells and block their signals for blood vessel growth to “feed” the tumor. This may help shrink tumors or slow their growth so that they can be surgically removed.
- Angiogenesis inhibitors: Target tumor blood vessels to slow or stop growth.
- mTOR inhibitors: Target a protein called mTOR to help stop cancer cells from growing and dividing.
- Epidermal growth factor receptor inhibitors: Target a protein on the surface of cells (EGFR) to stop cancer cell growth.
Immunotherapy is the groundbreaking use of drugs, therapeutic vaccines, viruses, antibodies and cell-based techniques that stimulate the patient’s own immune system to fight cancer. Research in kidney cancer and other cancers suggests that combining immunotherapy drugs with various other drugs may improve the number of patients who achieve responses.
Kidney cancer is an unusual type of cancer that has an odd but sometimes very favorable outcome of “spontaneous regression.” Doctors believe that in some cases, the patient’s immune system gets activated and metastatic tumors subsequently and unpredictably regress and disappear following surgery and nephrectomy (surgical kidney removal) without any other intervention.
Commonly used immunotherapy options include:
- Monoclonal antibody (mAb) therapy: A type of protein that attaches to and blocks the action of cancer cells.
- Cytokine therapy: Cytokines are proteins that stimulate immune cells. They occur naturally in the body but can also be made in a laboratory to help with cancer treatment.
“It may be easy for patients to think there’s only one approach to treating localized or systemic kidney cancer, and there are actually many different approaches. We are able to tailor those approaches to the individual patient, their condition, and their preferences. We help them learn there are many options out there to consider before making a decision.” – Daniel Geynisman, MD, medical oncologist and kidney cancer specialist