• Other Treatments for Kidney Cancer

    Biologic Therapy

    Biologic therapy (also called immunotherapy) uses drugs to improve the way your body fights cancer. The therapy attempts to repair, stimulate, or enhance the immune system so that it can identify and fight the cancer cells more effectively. It may be used alone or in combination with other treatments.
    Cytokines are reproduced proteins that activate the body's immune system. Examples of cytokines used to treat kidney cancer include interferon alfa and interleukin 2 ( IL-2, aldesleukin, or proleukin).
    Interleukin 2 (IL-2) is given by injection under the skin or by IV for metastatic kidney cancer. Treatment may be given in cycles separated by a rest period. In some cases, IL-2 results in shrinking the tumor. In others, the tumor may disappear completely, though there is a chance of recurrence. IL-2 treatment is not appropriate for all people with metastatic kidney cancer because of the serious side effects.
    Common Side Effects
    IL-2:

    Targeted Therapy

    Targeted therapies attempt to interfere with the growth of the tumor by blocking the formation of new blood vessels around the tumor. Though not a cure, these medications may shrink or slow the growth, and/or spread of tumors, and extend survival time.
    Bevacizumab
    Bevacizumab works by slowing the growth of new blood vessels. At times it may be combined with interferon alfa, which boosts specific components of the immune system.
    The most common side effects when bevacizumab is used alone include:
    • High blood pressure
    • Bleeding
    • Intestinal perforation or fistula (an abnormal opening between 2 bodily structures)
    • Blisters on the palms of the hands or soles of the feet
    • Diarrhea
    • Constipation
    • Loss of appetite
    • Fatigue
    • Weakness
    • Altered taste
    • Mouth irritation
    • Protein in the urine
    • Difficulty breathing
    The most common side effects when bevacizumab is used in combination with interferon alfa include:
    • Fatigue
    • Weakness
    • Protein in the urine
    • High blood pressure
    • Gastrointestinal bleeding or perforation
    Axitinib
    Axitinib works by preventing the growth of new blood vessels to tumors through various pathways. The most common side effects include:
    • Diarrhea
    • High blood pressure
    • Loss of appetite
    • Nausea or vomiting
    • Constipation
    • Blisters on the palms of the hands or soles of the feet
    • Weakness
    • Difficulty speaking
    Everolimus
    Everolimus reduces the blood supply and slows tumor growth. It may be used when other, similar types medications are no longer working. The most common side effects include:
    • High blood pressure
    • Rash
    • Constipation
    • Mouth irritation
    • Anemia
    • Slower wound healing
    • Fatigue
    • Weakness
    • Menstrual problems
    • Cough
    • Difficulty breathing
    Pazopanib
    Pazopanib works by preventing the growth of new blood vessels to tumors. The most common side effects include:
    • Diarrhea
    • High blood pressure
    • Hair color changes
    • Nausea or vomiting
    • Loss of appetite
    Sorafenib
    Sorafenib targets several different pathways of tumor growth. The most common side effects include:
    • Rash
    • Diarrhea
    • High blood pressure
    • Redness
    • Pain
    • Swelling
    • Blisters on the palms of the hands or soles of the feet
    • Nerve damage
    Sunitinib
    Sunitinib attacks both blood vessel growth and other targets that stimulate cancer cell growth. The results show tumor shrinkage in one third of the patients treated. Side effects may include:
    • Diarrhea
    • Change in skin color
    • Mouth irritation
    • Weakness
    • Altered taste
    • Fatigue
    • High blood pressure
    • Bleeding
    • Hypothyroidism
    Temsirolimus
    Temsirolimus works to inhibit cell growth. The most common side effects include:
    • Skin rash
    • Feeling weak
    • Mouth irritation
    • Nausea
    • Loss of appetite
    • Fluid buildup in the face or legs
    • Increases in blood sugar and cholesterol levels

    Dialysis

    If both kidneys are removed or no longer function, dialysis will be necessary. Dialysis mimics kidney function by filtering wastes and excess fluids from the blood. It is a permanent treatment if a kidney transplant cannot be done. There are 2 main types of dialysis:
    • Hemodialysis—Blood is pumped from a vein into a machine (called a dialyzer) outside of the body. The machine filters the blood and returns it to the body. Treatment is typically done 3 times per week for up to 4 hours. Treatment times and frequency can vary from person to person.
    • Peritoneal—A sterile solution enters the abdominal cavity through a tube. The abdominal cavity is lined with blood vessels. The blood vessels and solution interact to draw wastes and excess fluids into the solution. The solution is then drained from the abdominal cavity. Peritoneal dialysis can be done at home, often during the night, eliminating the need to travel to a hemodialysis facility for treatment.

    References

    Escudier B, Eisen T, Standler WM, et al. Sorafenid in advanced clear-cell renal cancer carcinoma. N Engl Med. 2007;356(2):125-134.

    Kidney cancer. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/kidneycancer. Accessed December 30, 2015.

    Kidney cancer (adult)—renal cell carcinoma. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003107-pdf.pdf. Accessed December 30, 2015.

    Renal cell carcinoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114704/Renal-cell-carcinoma. Updated March 14, 2016. Accessed October 6, 2016.

    Renal cell carcinoma (adenocarcinoma of the kidneys). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/renal-cell-carcinoma. Updated November 2013. Accessed December 30, 2015.

    Rini BI, Halabi S, Rosenberg JE. Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. J Clin Oncol. 2010;28(13):2137-2143.

    Treatment options for renal cell cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq#section/%5F93. Updated July 7, 2015. Accessed December 30, 2015.

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