Biological treatments for kidney cancer

There are several types of these treatments, including cancer growth inhibitors|, interferon, aldesleukin and monoclonal antibodies|. They may be used to try to control locally-advanced kidney cancer and kidney cancer that has spread to other parts of the body. For some people they may help to shrink the cancer or slow its growth.

Cancer growth inhibitors Back to top

Sunitinib (Sutent®)| is used as an initial treatment for people with locally-advanced kidney cancer (stage 3) or kidney cancer that has spread to other areas of the body (stage 4). It is a type of drug called a multi-targeted kinase inhibitor. It works by interfering with signals that tell cells to grow and slows the growth of new blood vessels in the tumour.

It’s usually taken daily as a tablet for four consecutive weeks with a two-week rest period. This makes up a cycle of treatment. Your doctor may adjust the dose during your treatment.

Common side effects of sunitinib include:

• tiredness
• skin changes, such as a rash or thinning hair
• hand-foot syndrome, where the palms of the hands and the soles of the feet often become reddened and sore and can sometimes swell
• a sore mouth
• raised blood pressure.

Sunitinib can also affect the thyroid gland, making it work less effectively. This is called hypothyroidism and it may cause tiredness and other symptoms. During your treatment, you’ll have blood tests to check your thyroid function.

In addition to sunitinib, other cancer growth inhibitors are sometimes used to treat advanced kidney cancer. They include:

• sorafenib (Nexavar®)
• temsirolimus (Torisel®)
• everolimus (Afinitor®).

Although these drugs are licensed and can be used in the UK they have not been approved by NICE (National Institute for Health and Clinical Excellence), an independent organisation that gives advice on which new drugs and treatments should be available on the NHS. This means that they’re not generally available, but they may be available as part of a clinical trial|.

NICE is in the process of assessing a relatively new cancer growth inhibitor called pazopanib to see if it should be approved to treat advanced kidney cancer.

Interferon alpha Back to top

Interferon| is a type of immunotherapy which is routinely used for kidney cancer. It’s a substance normally produced by the body to fight viral infections such as flu, but has a number of effects on the immune system. Interferon can be produced in a laboratory.

The type of interferon used to treat cancer of the kidney is called interferon alpha-2a (Roferon-A®). It’s usually given three times a week by injection under the skin (subcutaneously). The injections may be slightly uncomfortable. You, or your relatives, can be taught to give the injections at home, and you can use either a pen-injection device or a pre-filled syringe, which makes it easier to do this. Your hospital team can arrange for a district nurse to visit you at home if you need help with these injections.

In the first week or two of treatment, interferon often causes side effects similar to flu symptoms – especially chills, a high temperature, headaches, and aching in the back, joints and muscles. You may also feel tired, sick, and lose your appetite. Although these symptoms are uncomfortable at the time, they tend to become less severe as the treatment continues. 

Aldesleukin Back to top

Aldesleukin (Proleukin®)| is another type of immunotherapy which is sometimes used for cancer of the kidney. It’s an artificial version of a protein called interleukin-2 (IL-2) that occurs naturally in the body and stimulates a type of blood cell called lymphocytes to fight infection.

Aldesleukin is a complex treatment which is used to treat some people with kidney cancer. Because the treatment has significant side effects, it is only given in specialist centres. You’ll need to be an inpatient during the treatment which is usually given as a drip (intravenously).

Your consultant will let you know if this treatment may be suitable for you.

Monoclonal antibodies Back to top

Bevacizumab (Avastin®)| is a treatment known as a monoclonal antibody. It works by stopping kidney cancers from developing new blood vessels. This reduces the cancer’s supply of oxygen and nutrients, which causes the tumour to shrink, or at least stop growing.

Bevacizumab is licensed to treat advanced kidney cancer when it’s given with interferon. However, this treatment is not widely available as it has not been approved by NICE.