Kidney Cancer Treatments are Improving in 2018

The most common type of kidney cancer is renal cell carcinoma (RCC). In most cases, RCC is diagnosed in older people who are typically age 64 or older. It is very uncommon to see kidney cancer in people younger than age 45.

As with many other cancers, kidney cancer typically doesn’t cause symptoms in its early stages. By the time common symptoms do arise, the cancer may be more difficult to treat.

Genetics & Kidney Cancer

Certain changes (mutations) in genes can increase a person’s risk for getting cancer. In regards to kidney cancer, scientists are studying several genes that appear to change normal kidney cells into cancerous ones. These are known as oncogenes and tumor suppressor genes.

Cancer likely involves multiple gene mutations, which can either be acquired or inherited. Acquired mutations are mutations that happen during a person’s lifetime. In other words, they are non-hereditary. Inherited changes in DNA, on the other hand, can lead to conditions running in some families that increase the risk of kidney cancer. Many studies focus on inherited gene mutations.

Associated genes and syndromes that have been identified as the possible cause of inherited cancer risk for kidney cancer in some renal cell carcinoma-prone families include:

• von Hippel-Lindau disease (VHL gene)
• Hereditary leiomyomatosis and renal cell cancer (FH gene)
• Birt-Hogg-Dube syndrome (FLCN gene)
• Familial renal cancer (SDHB and SDHD genes)
• Hereditary papillary renal carcinoma (MET gene )

If you have a family history of kidney cancer or other cancers linked to these syndromes, you may want to talk with your doctor or one of the genetic counselors at Compass Oncology about genetic testing to see if testing is something would be an option for you.

Advances in Kidney Cancer Treatment

Targeted Therapies

Because traditional chemotherapy is not very effective against advanced kidney cancer, doctors are turning to targeted therapies for treating kidney cancers that cannot be removed surgically or have spread to other areas of the body. Targeted therapy is a special type of chemotherapy that goes after cancerous cells while leaving healthy, normal cells alone. While targeted therapies are currently given separately, clinical trials are being conducted to see if combining these drugs with each other or with other methods of treatment may offer better results.

New research studies show that a new class of drugs called HIF-2 inhibitors is more effective and better tolerated than sunitinib (Sutent®), the current standard of care drug used for treating kidney cancer. HIF proteins appear to be a significant driver of kidney cancer so being able to specifically target them could result in a more effective treatment.

Immunotherapy

Immunotherapy, a category of cancer treatment that uses the body’s immune system to fight cancer, has become an important part of treating some types of cancer, including kidney cancer. Currently, there are three main types of immunotherapy being used to treat cancer, which include:

• Monoclonal antibodies: laboratory-produced molecules that specifically target a certain antigen, such as one found on cancer cells. They are engineered to serve as substitute antibodies that can restore, enhance, or mimic the immune system's attack on cancer cells and bind to antigens that are generally more numerous on the surface of cancer cells than healthy cells.
• Immune checkpoint inhibitors: drugs that target molecules (“checkpoints”) on certain immune cells that need to be activated (or inactivated) to start an immune response against foreign cells.
• Cancer vaccines: a type of immunotherapy that work to boost the body's natural defenses to fight a cancer. Cancer vaccines are also called therapeutic vaccines.  

More research, which includes clinical trials, is being directed toward better understanding how to help the immune system destroy cancer cells. You can learn more about specific advancements in immunotherapy be reading What’s new in cancer immunotherapy research? published by The American Cancer Society.

Kidney Cancer & Cancer Vaccines

Cancer vaccines belong to a class of substances known as biological response modifiers. Biological response modifiers work by stimulating or restoring the immune system’s ability to fight infections and disease.

While vaccines are not a major type of treatment at this time, cancer researchers are continually working to improve how they develop them. There are several types under investigation that can help kidney cancer patients:

• Vaccines are often administered along with other medicines to help the vaccine boost the body’s immune response while undergoing cancer treatment. Additionally, researchers are studying whether vaccines work better when used alone or when used alongside other types of cancer treatments.
• Some cancer vaccines are made specifically for kidney cancer patients. These types of vaccines are produced from the patient’s tumor and given after surgery to alert the body’s immune system to destroy any leftover cancer cells. Other vaccines are made from proteins found on the surface of kidney cancer cells or blood vessel cells found in the tumor.

Many doctors are testing the use of several cancer vaccines in both treating kidney cancer and preventing recurrence for people with late-stage renal cell carcinoma.

Concerned about your risk or finding the latest kidney cancer treatments?

Compass Oncology offers a Genetic Risk Evaluation & Testing Program (GREAT) as well as clinical trials that are not available anywhere else in the Portland and Vancouver area for kidney cancer. If you are concerned about your risk or you are a kidney cancer patient in the Portland or Vancouver area and would like to meet with one of our kidney cancer specialists, please schedule an appointment at a location convenient for you.