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)
A tyrosine kinase targeted therapy drug (tyrosine kinase inhibitor) used for advanced, recurrent kidney cancer is lenvatinib (Lenvima). It may be used in combination with everolimus if you have been given VEGF targeted therapy before.
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).
- 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 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.
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.
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.