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 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)
If your cancer has stopped responding to VEGF or mTOR drugs, you may be offered nivolumab (Opdivo), which is a PD-1 checkpoint inhibitor.
There are no standard treatments for kidney cancer that has stopped responding to targeted therapy drugs.
External beam radiation therapy may be offered to relieve pain and other symptoms from brain metastases, bone metastases or lung metastases.
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 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). It is rarely used in Canada because targeted therapies are better at treating kidney cancer.
Immunotherapy may be used in specialized centres to treat people who have kidney cancer that no longer responds to targeted therapy. Your healthcare team will decide if immunotherapy is a good treatment option for you.
Cytokines are the type of immunotherapy used for recurrent kidney cancer. Cytokines are proteins made and released by immune system cells. The 2 cytokine drugs that may be used are:
- high-dose intravenous interleukin-2 (Aldesleukin, Proleukin)
- interferon alfa (Intron A, Wellferon) given as an injection under the skin (subcutaneous injection)
High-dose intravenous interleukin-2 can have serious side effects. It must be given in centres that have experience giving this treatment.
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.
You may be asked if you want to join a clinical trial for kidney cancer. Find out more about clinical trials.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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