Navigating Treatment
There are certain diagnoses that can make us stop and evaluate our whole lives, and being told that we have cancer is one of the big ones. Fortunately, cancer research continues to develop treatments to improve quality of life and survival. Today, we’re going to look in-depth at one course of treatment for kidney cancer: immunotherapy. This article will outline what kidney cancer is, its symptoms, why doctors may use immunotherapy treatments and what side effects to watch for.
What is Kidney Cancer?
Kidney cancer is a cancer that develops in the cells of the kidneys characterized by a malignant tumor. These tumors are groups of cancer cells that grow into other cells and tissues to destroy them. In severe cases, the cancer cells can spread or metastasize to other parts of the body. Most kidney cancers start in the tubules of the kidneys and are referred to as classic renal cell or clear cell carcinomas.
There are roughly 628,000 people in the US currently living with kidney cancer, with almost 82,000 new cases being diagnosed yearly. While the five-year survival rate is typically just over 77%, in 2024, there will be an estimated 14,390 deaths from kidney cancer. That’s why early detection and appropriate treatment are so important.
What are the Signs of Kidney Cancer?
When it comes to the detection and treatment of kidney cancer, knowing what to watch for can help increase survival and help your doctor design a targeted treatment plan. If you experience the following symptoms, make sure to discuss them with your doctor as soon as possible:
- Consistent pain in your back or side.
- Bloody urine–this can look pink, cola-colored or red.
- Fever.
- Exhaustion.
- Appetite loss.
- Unexplained weight loss.
What is Immunotherapy for Kidney Cancer?
Immunotherapy is a cancer treatment that stimulates and strengthens your immune system to help fight off cancer cells. Immunotherapy is not considered a first-line treatment for kidney cancer but is used in cases where other approaches are not appropriate or no longer working. Your oncologist may recommend immunotherapy if:
Your body is no longer responding to targeted therapy drugs designed to kill cancer cells.
You experience an allergic reaction or adverse side effects to targeted therapy drugs.
Based on the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) you have poor or intermediate metastatic kidney cancer.
What are Common Immunotherapy Drugs Used to Treat Kidney Cancer?
There are a couple of different classes of immunotherapy drugs that may be used to treat kidney cancer depending on the stage and the patient’s unique needs.
1. Immune Checkpoint Inhibitors
To keep our immune system from attacking healthy and normal cells, it has certain proteins built into the body called checkpoints. Their job is to tell immune cells to back off and turn their attention away from our tissues and to pathogens or viruses.
Unfortunately, kidney cancer cells can sometimes hijack these checkpoint proteins and use them to protect themselves from being detected and destroyed by the immune system. That’s where this class of immunotherapy drugs comes in.
Immune checkpoint inhibitors (ICI) block these checkpoint proteins from doing their jobs and thus allow the immune system, via T-cells, to attack and destroy kidney cancer cells. Two specific ICI drugs are:
- Pembrolizumab (Keytruda): This ICI is often used in conjunction with the targeted therapy drug axitinib (Inlyta) to treat metastatic or advanced cancers that have not been treated with systemic therapies.
- Nivolumab (Opdivo): This ICI is often used if the kidney cancer cells are not responding to targeted therapy treatment. Sometimes, it is combined with other targeted treatments to help treat advanced or metastatic cancers that cannot be treated via radiation or surgery.
2. Cytokines
These immunotherapy drugs are not as commonly used as immune checkpoint inhibitors since many people do not respond to them, and there can be severe side effects. If you have studied the immune system before, then you’ll know that our bodies naturally make cytokines, but when it comes to immunotherapy drugs, these cytokines are made in a lab. They are designed to stimulate the immune system to destroy kidney cancer cells.
The most common type of cytokines given during immunotherapy are high-dose interleukin-2 (aldesleukin, Proleukin), but they are rarely used since the side effects can be severe. The only time they are recommended for use is if the patient is strong enough to withstand any potential side effects at cancer treatment centers with experience administering this immunotherapy drug.
What are the Side Effects of Immunotherapy?
When it comes to cancer treatment, rarely, a patient won’t experience some form of side effects, but the type and extent are dependent on the person. Common symptoms experienced by those undergoing immunotherapy drug treatment include:
- Low blood pressure.
- Diarrhea.
- Cough.
- Loss of appetite.
- Nausea and vomiting.
- Flu-like symptoms: chills, fever and muscle or joint aches.
- Rashes and itching skin.
- Exhaustion.
During immunotherapy treatment, it’s important to keep track of your symptoms and side effects and to communicate them to your care team regularly to ensure you are on the best possible plan for your needs.
From Diagnosis to Recovery
Remember, when it comes to treating kidney cancer, prevention and early detection are crucial. If you experience any ongoing or worrying symptoms that you can’t seem to explain, book an appointment with your doctor to get checked out sooner rather than later.
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