Leading Kidney Cancer Treatment Options

Treating Advanced Kidney Cancer

Your kidney cancer may be described by your care team as “advanced.”

Kidney cancer is considered “advanced” when:

Biopsy shows your cancer is high-risk of being aggressive or difficult to treat
It is Stage 3 or Stage 4, meaning cancer has:
- Grown beyond the kidney to nearby organs, tissue or lymph nodes
- Spread to distant lymph nodes or organs (metastasized) in other places of the body

Advanced kidney cancer is harder to treat and may require more than one approach. New, innovative treatments are giving hope to people with advanced kidney cancer. You may be recommended for one or a combination of treatments, including:

Systemic Treatment | Targeted Therapy | Immunotherapy
Surgery | Ablation | Embolization
Radiation Treatment
Clinical Trials

Systemic Treatment

For individuals diagnosed with advanced kidney cancer, "systemic treatment" may be recommended. This approach involves medication that circulates through the bloodstream, reaching and attacking cancer cells throughout the entire body. Systemic treatments are administered either in pill form or as an IV infusion, targeting cancer cells wherever they are located.

The primary systemic treatments for kidney cancer include:

Targeted Therapy

Targeted therapy is a sophisticated approach to treating cancer. Instead of killing cancer cells directly, targeted therapy disrupts what cancer cells need to grow and spread. Targeted therapy works in several ways by:

Grown beyond the kidney to nearby organs, tissue or lymph nodes
Spread to distant lymph nodes or organs (metastasized) in other places of the body
Latest research
Your type of tumor(s)
Where your cancer is located
Your Overall Health
How you’ve responded to previous treatment
Genetic make-up of your cancer, determined through genomic testing for inherited cancers, when applicable
Blocking proteins that help cancer cells divide and spread
Cutting off blood supply that tumors need to grow

Tyrosine Kinase Inhibitor (TKI)

The most common targeted therapy for kidney cancer are TKIs. They block proteins (tyrosine kinases) that help cancer cells divide and spread, and the growth of blood vessels that tumors need to survive.

Drugs Include*: Sutent® (sunitinib); Inlyta® (axitinib); Lenvima® (lenvatinib); Cabometyx® (cabozantinib); Fotivda® (tivozanib); Nexavar® (sorafenib); Votrient® (pazopanib)

Common Side Effects: stomach pain, constipation, diarrhea, loss of appetite, nausea and vomiting, fatigue, skin rash

mTOR Inhibitor

VEGF Inhibitor

HIF-2α Inhibitor

Immunotherapy

Immunotherapy is designed to help your body’s own immune system fight your kidney cancer.

Checkpoint Inhibitor

The most common immunotherapy for kidney cancer is a checkpoint inhibitor. All of our cells have “immune checkpoints” on their surface to keep the immune system from attacking itself. Checkpoint inhibitors enhance your own immune system to recognize the cancer cell and kill it.

Checkpoint Inhibitors for Kidney Cancer Include*: Yervoy® (ipilimumab); Keytruda® (pembrolizumab); Opdivo® (nivolumab); Bavencio® (avelumab)

Common Side Effects: diarrhea, loss of appetite, nausea and vomiting, constipation, stomach pain, fatigue and weakness, shortness of breath, headache, skin rash

(*FDA-approved systemic treatments for kidney cancer reviewed (add date here))

Surgery

In some cases of advanced kidney cancer, surgery may be considered in combination with other treatments.

While not curative for advanced kidney cancer, surgery can help:

Slow or reduce cancer spread in the abdominal cavity
Slow or reduce the spread if cancer has metastasized to other parts of the body
Relieve symptoms such as pain and improve function and quality of life

Your care team will recommend the approach that is best for you based on size and location of your tumor(s). Your physical health and medical history also are considered.

Robotic or Open Surgery

Ablation

Ablation may be recommended to destroy or reduce the size of metastatic tumors. Ablation is a minimally invasive procedure that is performed by a surgeon or interventional radiologist.

A thin, hollow probe is inserted through the skin. The probe is guided to the tumor using ultrasound, CT or MRI imaging. Hot or cold therapy is passed through the probe. Because it’s done under image guidance, ablation is highly targeted with little damage to surrounding healthy tissue.

There are two kinds of ablation:

Radiofrequency Ablation (RFA): High-energy radio waves heat and destroy cancer cells.

Cryoablation: Extremely cold gases destroy cancer cells.

Embolization

Radiation Treatment

Radiation therapy may be recommended when cancer is advanced and has spread beyond the kidney. Radiation delivers high levels of energy to kill cancer. Doctors may recommend radiation therapy for:

Controlling the spread of cancer
Managing symptoms and side effects such as bleeding and pain
Shrinking larger tumors, if they affect other organs or so they can be surgically removed
Relieving symptoms and improving quality of life

IMRT (Intensity-modulated Radiation Therapy)

IGRT (Image-guided Radiation Therapy)

SBRT (Stereotactic Body Radiation Therapy)

Clinical Trials

New treatments continue to be developed for advanced kidney cancer. Some are only available through clinical trials. By participating in a clinical trial, you receive a new, innovative treatment that has been tested and tweaked over years and is being introduced to a small group before the general public.

If you have advanced kidney cancer, you may consider participating in a clinical trial for reasons including:

Previous treatment failed or was not as effective as you had hoped
There is a new treatment targeting kidney cancer with your genomic profile available only through clinical trial
No current treatment exists for your type of kidney cancer and you want to try a new approach.

It’s important to note that nothing is done in a clinical trial without your full consent. You can withdraw from a clinical trial at any time. Ask your care team if a clinical trial is an option for you.

Learn more about Clinical Trials

Side Effects

Each person responds differently to systemic treatment, surgery and radiation treatment of kidney cancer. Learn more about possible side effects, steps you can take at home and when to contact your provider.

Localized Kidney Cancer

If your kidney cancer is localized and confined to the kidney without spreading, explore your treatment options and strategies for recovery.

Localized Kidney Cancer Treatment