Kidney cancer

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Treatments for recurrent kidney cancer

The following are treatment options for recurrent kidney cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. The treatments you are offered will depend on where the cancer has come back and the treatments you have already received.

Targeted therapy

Targeted therapy is the standard treatment for recurrent kidney cancer. Targeted therapy uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells.

VEGF targeted therapy drugs used for recurrent kidney cancer include:

  • sunitinib (Sutent) – usually the first drug to be used as it has been shown to be the most effective
  • sorafenib (Nexavar)
  • pazopanib (Votrient)
  • axitinib (Inlyta)

mTOR targeted therapy drugs used for recurrent kidney cancer include:

  • temsirolimus (Torisel)
  • everolimus (Afinitor)

There are no standard treatments for kidney cancer that has stopped responding to targeted therapy drugs.

Surgery

If the kidney cancer has spread only to the brain or the lung, you may be offered surgery to treat it. Find out more about treatment for brain metastasis or lung metastasis.

Radiation therapy

External beam radiation therapy may be offered to relieve pain and other symptoms from brain metastases, bone metastases or lung metastases.

Ablation therapy

Ablation therapies use heat or cold to destroy the kidney tumour. You may be offered ablation therapy if you are not well enough to have surgery or if you only have one working kidney.

Immunotherapy

Immunotherapy is a type of biological therapy that uses the immune system to help destroy cancer cells. It may be offered to a few people with recurrent clear cell, or conventional, renal cell carcinoma (RCC).

  • 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.
  • High-dose interleukin-2 (Aldesleukin, Proleukin) is the most common cytokine drug 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).

Chemotherapy

Chemotherapy is rarely used for kidney cancer. You may be offered chemotherapy if you have:

  • renal cell carcinoma (RCC) with sarcomatoid or rhabdoid features
  • a type of RCC that isn’t a clear cell type
  • cancer that no longer responds to other therapies, such as targeted therapy

Chemotherapy is used to relieve pain or control the symptoms of advanced kidney cancer (called palliative chemotherapy). Unfortunately, response rates to chemotherapy are usually poor.

Because chemotherapy is rarely used to treat kidney cancer, there are no standard drugs or drug combinations.

Clinical trials

You may be asked if you want to join a clinical trial for kidney cancer. Find out more about clinical trials.

cytokine

A substance made by cells of the immune system. Cytokines allow immune system cells to communicate with each other and thus help carry out the body’s immune response (the immune system’s reaction to the presence of foreign substances in the body).

Cytokines are produced by the body or can be made in a lab.

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