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Immunotherapy for kidney cancer
Some people with advanced or metastatic kidney cancer may have immunotherapy. Immunotherapy uses natural or artificial substances that change the way cells behave. Different types of immunotherapies work in different ways. Some types kill cancer cells or control or change how they behave. Other types strengthen the body’s immune system, control symptoms or lessen side effects of treatment. Immunotherapy is also called biological therapy, biotherapy or biological response modifiers (BRMs).
You may be offered immunotherapy therapy if:
- you have an allergic reaction to or severe side effects from targeted therapy drugs
- your kidney cancer no longer responds to targeted therapy
Your healthcare team will consider your personal needs to plan the drugs, doses and schedules for immunotherapy.
Immunotherapy drugs used for kidney cancer
The following drugs are used in immunotherapy for kidney cancer.
Immune checkpoint inhibitors
The immune system normally stops itself from attacking normal cells in the body by using specific proteins called checkpoints, which are made by some immune system cells. Kidney cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immune checkpoint inhibitors work by blocking the checkpoint proteins so immune system cells (called T cells) attack and kill the cancer cells. Immune checkpoint inhibitors are showing a lot of promise in the treatment of kidney cancer.
Nivolumab (Opdivo) is used for kidney cancer that has a large number of PD-L1 proteins on the cancer cells. It may be offered if the kidney cancer is no longer responding to a VEGF or mTOR targeted therapy drug.
Cytokines are proteins made by certain cells of the immune system. They can also be made in a lab and given as a drug. Cytokines act as chemical messengers so the immune system cells communicate with each other and help control the immune response. Cytokines are rarely used because only a small number of people with kidney cancer will respond to cytokines, and there are severe treatment side effects.
High-dose interleukin-2 (Aldesleukin, Proleukin) is the most common cytokine used. It can cause serious side effects, so it must only be given at cancer centres that have experience giving this treatment. High-dose interleukin-2 is only given to people who are healthy enough to tolerate the side effects.
Interferon alfa (Intron A, Wellferon) is given by injection under the skin (called subcutaneous injection).
Side effects can happen with any type of treatment for kidney cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
Side effects can develop any time during, immediately after or a few days or weeks after immunotherapy. Sometimes late side effects develop months or years after immunotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Some common side effects of immunotherapy for kidney cancer include:
- flu-like symptoms (including fever, chills, muscle and joint pain)
- allergic reactions (including difficulty breathing)
- nausea and vomiting
- skin problems
- loss of appetite
High-dose interleukin-2 can cause serious and even life-threatening side effects. As a result, it is only given in treatment centres that have experience in giving this treatment. The side effects of nivolumab and interferon alfa are not as severe.
Your healthcare team will watch you carefully so that serious side effects can be treated right away. The sooner you tell them of any problems, the sooner they can treat them. If you have a lot of trouble with side effects, your healthcare team may have to stop treatment.
Information about immunotherapy therapy drugs
Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.
Questions to ask about immunotherapy
A type of lymphocyte (white blood cell) that helps control immune response (the immune system’s reaction to the presence of foreign substances in the body), fight infection and destroy abnormal cells, including cancer cells.
Also called T lymphocyte.
The immune system’s reaction to the presence of foreign substances in the body.