Kidney cancer

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Research in kidney cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat kidney cancer. They are also looking for ways to improve the quality of life of people with kidney cancer.

The following is a selection of research showing promise for kidney cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year.

Diagnosis and prognosis

A key area of research looks at better ways to diagnose and stage kidney cancer. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.

Biomarkers are substances, such as proteins, genes or pieces of genetic material like DNA and RNA, that are found naturally in the body. They can be measured in body fluids like blood and urine or tissue that has been removed from the body. A gene mutation or a change in the normal amount of a biomarker can mean that a person has a certain type of cancer. Doctors are trying to find tumour markers that look for these changes to see which people may have kidney cancer or be at risk for kidney cancer. Tumour marker tests may also help doctors predict the prognosis or response to treatment in people with kidney cancer. Researchers are looking at many tumour markers to see if they can help doctors diagnose, predict a prognosis for and find out which treatments will benefit a person with kidney cancer. PD-1 and PD-L1 are examples of biomarkers that may help predict which people with kidney cancer are most likely or unlikely to benefit from immunotherapy (BMC Urology, PMID 28086852).

The immune score is the number of T cells (a type of white blood cell) inside a tumour. T cells are an important part of the immune system. They are often found in the area that surrounds cancer cells within a tumour (called the tumour microenvironment). Researchers are trying to find out if the immune score can help doctors predict which people are most likely or unlikely to benefit from immunotherapy (Genome Biology, PMID 27855702).

Gene-based tests find differences between normal genes and genes that are changed (mutated) in cancer cells. Microarray analysis is a type of gene-based test that allows researchers to look at many genes together to see which ones are turned on and which ones are turned off. Analyzing many genes at the same time to see which are turned on and which are turned off is called gene expression profiling. Researchers hope that developing more gene-based tests will help doctors identify the best treatments for certain cancers, including kidney cancer. Gene-based tests may also help doctors tailor more treatments to each person’s cancer based on their unique genetic makeup (BJU International, PMID 28432832; Scientific Reports, PMID 25974855).

Liquid biopsy is a test that looks for cancer cells (called circulating tumour cells or CTCs) or pieces of tumour DNA (called circulating tumour DNA) in the blood or other body fluids. Some research shows that testing the blood for cancer cells can help predict prognosis in people with metastatic kidney cancer. A study found that people with metastatic kidney cancer who have 3 or more CTCs in the blood seemed to have lower rates of survival (ASCO, Abstract 4568).

PET/CT combines a PET and a CT scan into one procedure. Researchers are studying PET/CT to see if it can predict an outcome for people with kidney cancer (Oncology Letters, PMID 26622577). Find out more about positron emission tomography (PET) scan and computed tomography (CT) scan.

Nomograms are statistical models that doctors can use to interpret data and predict a prognosis for people with cancer. Nomograms allow doctors to study several factors at the same time to predict an outcome. Nomograms for kidney cancer have looked at blood cell counts, performance status and time to treatment. They may help doctors predict survival for renal cell carcinoma (Lancet Oncology, PMID 25681967; International Journal of Urology, PMID 25428139).

Diabetes may increase the risk of developing kidney cancer. Studies show that people who have diabetes and develop kidney cancer have a higher risk that the cancer will come back (recur) after treatment and a shorter survival compared to people with kidney cancer who don’t have diabetes (Medicine, PMID 26131819, PMID 25501064; Journal of Urology, PMID 26066406).

Find out more about research in diagnosis and prognosis.

Treatment

Researchers are looking for new ways to improve treatment for kidney cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for kidney cancer.

Robotic surgery

Robotic surgery uses a computer and instruments connected to robotic arms. The operation is done through several small incisions, or cuts. Some research shows that people who have robotic surgery compared with those who have open surgery to remove a kidney can have less pain after surgery, a quicker recovery, a shorter hospital stay and less scarring. Researchers are also trying to find out if robotic surgery can be used to remove part of the kidney (called a partial nephrectomy) (Urology, PMID 25917737, PMID 25892027).

Find out more about research in cancer surgery.

High-intensity focused ultrasound (HIFU)

HIFU focuses ultrasound waves to create intense heat, which destroys tissue. Researchers are studying HIFU as an alternative to surgery for some types of kidney tumours (Journal of Cancer, PMID 26918034; Advances in Experimental Medicine and Biology, PMID 26486331; International Journal of Hyperthermia, PMID 25367011).

Find out more about research in hyperthermia treatments.

Targeted therapy

Targeted therapy uses drugs to target specific molecules (for example, proteins) on the surface of or inside cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells.

Advances in targeted therapy have improved survival for people with kidney cancer. A study compared survival for people diagnosed with advanced kidney cancer between 2000 and 2005 (before targeted therapy was available) with those diagnosed with advanced kidney cancer between 2006 and 2010 (when targeted therapy was available). The results showed that people with advanced kidney cancer who were treated with targeted therapy survived longer than those who weren’t treated with targeted therapy (Cancer Medicine, PMID 26645975).

Cabozantinib (Cabometyx) is a type of tyrosine kinase inhibitor. It is a promising new targeted therapy for advanced renal cell carcinoma when the recommended targeted therapies (called first-line therapy) haven’t worked. People who took cabozantinib had a longer survival compared to those who took other second-line targeted therapy drugs (PLoS One, PMID 28886175; Expert Review of Anticancer Therapy, PMID 28633552; Current Treatment Options in Oncology, PMID 28286925; ASCO, Abstract 4578, Abstract 4570).

Find out more about research in targeted therapy.

Immunotherapy

Immunotherapy helps strengthen or restore the immune system’s ability to fight cancer. It is sometimes used to treat advanced kidney cancer when targeted therapy stops working.

Ipilimumab (Yervoy) is a checkpoint inhibitor that is showing promise in the treatment of advanced kidney cancer when given along with another checkpoint inhibitor called nivolumab (Opdivo) (Journal of Clinical Oncology, PMID 28678668). The immune system normally stops itself from attacking healthy cells in the body by having some cells make specific proteins called checkpoints. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immune checkpoint inhibitors are monoclonal antibodies that work by blocking the checkpoint proteins so T cells (a type of white blood cell) can attack and kill the cancer cells. Research presented at the European Society for Medical Oncology congress in September 2017 showed that the combination of ipilimumab and nivolumab lowered the risk of death by 37% compared to sunitinib (Sutent) in people with advanced kidney cancer who had an intermediate to poor outlook (prognosis).

Researchers are also looking at giving immunotherapy:

  • in combination with targeted therapy as a first-line therapy for people with advanced kidney cancer
  • after surgery (adjuvant immunotherapy) for people who no longer show signs of cancer but have a high risk that the cancer will come back

Find out more about research in immunotherapy.

Radiation therapy

Stereotactic radiosurgery delivers one large dose of radiation to a tumour as a single treatment (called a single fraction). This treatment doesn’t involve surgery because the doctor doesn’t make a cut to remove tissue. Some studies show that stereotactic radiosurgery may be a safe treatment option for people with kidney cancer that has spread to the brain (Journal of Oncology, PMID 26681942).

Find out more about research in radiation therapy.

Learn more about cancer research

Researchers continue to try to find out more about kidney cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage kidney cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for kidney cancer were first shown to be effective through clinical trials.

Find out more about cancer research and clinical trials.

immunotherapy

A treatment that uses and strengthens the immune system to fight disease including cancer.

Immunotherapy is a type of biological therapy.

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