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5 FAQs About Immunotherapy for Renal Cell Carcinoma

By

Jennifer L.W. Fink RN, BSN

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micrograph-of-kidney-cancer

Kidney cancer is one of the 10 most common cancers in both men and women–and the most common type of kidney cancer is called renal cell carcinoma. If caught and treated early, the prognosis is good. But until recently, doctors had few good options to offer patients whose cancer spread despite treatment.

All that is changing. In recent years, a new class of immunotherapy drugs, “checkpoint inhibitors,” was approved to treat certain types of skin and lung cancer. Since then, those drugs have shown promise fighting a lot of different cancers, including renal cell carcinoma.

What is immunotherapy, and how can it fight cancer? These experts explain this exciting new treatment.

2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

Here’s what you need to know about immunotherapy and renal cell carcinoma.

1. What is immunotherapy?

Immunotherapy, put simply, enables the immune system to attack cancer cells. When you get a cold, your body’s immune system attacks (and eventually destroys) the foreign germs that are causing your cough and sniffles. That doesn’t happen when a person develops cancer, because cancer cells are masters of disguise; they use special proteins to convince the immune system that they are normal parts of the body, so the body’s natural defenses leave them alone.  

Immunotherapy “unmasks” the cancer cells, so the body can attack and destroy them.

2. Has immunotherapy been used to treat advanced renal cell carcinoma in the past?

Two types of immunotherapies, called interleukin-2 and interferon-alpha, are man-made proteins that stimulate the immune system. Doctors have used them to treat renal cell carcinoma for at least the last decade, but the drugs don’t help everyone. Only about 10 to 20% of those treated see their cancers shrink, and only some of those people experience remission.

These drugs have some serious side effects too, including fluid buildup in the lungs, kidney damage, heart attacks and intestinal bleeding, so they can only be given to people who are healthy enough to withstand the side effects.

Now that new types of immunotherapies are emerging, interleukin-2 and interferon-alpha are being used less frequently.

3. How do “checkpoint inhibitors” treat renal cell carcinoma?

“Checkpoint inhibitors” essentially cancel the off-switch that cancer cells use to shut down the immune system, so the body can begin attacking the cancer. In November 2015, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo), a checkpoint inhibitor, to treat advanced renal cell carcinoma.

Right now, the drug is used to treat people whose cancer has gotten worse despite treatment with other medications. Unlike previous immunotherapy treatments, nivolumab is well-tolerated by most people. The most common side effects include fatigue, nausea, cough, itching, rash, loss of appetite, joint pain, constipation and diarrhea.

Nivolumab is given by intravenous (IV) infusion, usually every two weeks.

4. Does immunotherapy help people live longer with renal cell carcinoma?

In a head-to-head study that compared nivolumab with everolimus, a medication that is often used to treat people whose kidney cancer has progressed despite treatment, the patients who received the nivolumab lived more than five months longer than patients treated with the other medication. More people responded to immunotherapy treatment too; just over 21% of patients who received nivolumab responded, compared to fewer than 4% of those who received everolimus. Immunotherapy also seems to have a longer-lasting impact. The average sustained response–the amount of time the cancer remained under control–was almost two years for patients who received immunotherapy, versus just over a year for those who responded to everolimus.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Dec 23, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Biologic Therapy (Immunotherapy) for Kidney Cancer. American Cancer Society. http://www.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-treating-immunotherapy
  2. What’s New in Kidney Cancer Research and Treatment? American Cancer Society. http://www.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-new-researc
  3. Immunotherapy for Metastatic Renal Cell Carcinoma. MD Anderson Cancer Center. https://www.mdanderson.org/publications/oncolog/august-2014/immune-checkpoint-inhibitors-show-promise-against-metastatic-ren.html
  4. More Cancer Patients Gaining from Immune-Based Treatments. U.S. National Library of Medicine. https://medlineplus.gov/news/fullstory_161059.html
  5. Kidney Cancer (Adult) – Renal Cell Carcinoma. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003107-pdf.pdf
  6. Kidney Cancer. Cancer Research Institute. http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers/kidney-cancer
  7. FDA Approves Immunotherapy Nivolumab for Kidney Cancer. Cancer Network. http://www.cancernetwork.com/kidney-cancer/fda-approves-immunotherapy-nivolumab-kidney-cancer
  8. Emerging Role of Combination Immunotherapy Regimens in Metastatic Renal Cell Carcinoma. American Society of Clinical Oncology (ASCO). http://am.asco.org/daily-news/emerging-role-combination-immunotherapy-regimens-metastatic-renal-cell-carcinoma

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