Targeted and biological therapy drugs for kidney cancer
Targeted and biological therapy drugs are newer treatments used for kidney cancer.
These drugs work by stopping the cancer from making new blood vessels (cancer cells need new blood vessels to grow). Targeted therapies also interfere with signals that tell cancer cells to grow.
Sunitinib may be used as a first drug treatment for people who have stage 3 or 4 kidney cancer. It’s a type of drug called a cancer growth inhibitor.
It’s usually taken daily as a tablet for four weeks followed by two weeks off. This makes up a cycle of treatment. Your doctor may adjust the dose during your treatment.
Common side effects of sunitinib include:
skin changes such as a rash
hand-foot syndrome, where the palms of the hands and soles of the feet become red, sore and sometimes swollen
a sore mouth
loose bowel motions
raised blood pressure.
Sunitinib can also make the thyroid gland work less well, so during your treatment you’ll have blood tests to check this.
Pazopanib (Votrient®) and sorafenib (Nexavar®)
Pazopanib and sorafenib are other cancer growth inhibitors that can be used as a first treatment for advanced kidney cancer. Like sunitinib they’re taken as a tablet.
Everolimus is also given as a tablet and is usually used as a second treatment after another targeted therapy for advanced kidney cancer has been tried.
Temsirolimus is given as an injection into a vein (intravenously) and may also be used as a second drug treatment.
A new targeted therapy drug called Axitinib has recently been licensed. It works in a very similar way to sunitinib and pazopanib.
Bevacizumab is a treatment known as a monoclonal antibody. It also works by stopping kidney cancers from developing new blood vessels. Bevacizumab is licensed to treat advanced kidney cancer when it’s given with another drug called interferon (see below).
All these drugs are licensed to treat kidney cancer and can be used in the UK. Only sunitinib and pazopanib have been approved by the The National Institute for Health and Clinical Excellence (NICE) as possible first drug treatments for kidney cancer. NICE gives advice on which new drugs and treatments should be available on the NHS.
The Scottish Medicines Consortium (SMC), which gives advice on the use of new drugs in the NHS in Scotland, hasn’t approved sunitinib as a first drug treatment but has approved pazopanib in certain situations.
As a result, some of the drugs may not be widely available and they’re often given as part of a clinical trial.
Your specialist may apply to the health board for individual funding for a drug, or if you live in England they may be available through the Cancer Drug Fund. Your specialist will discuss this with you if they think any of these drugs are suitable for you.
We have a separate section about what you can do if a treatment isn’t available.
Denton's story of fatigue
Denton suffered from fatigue when he had treatment for prostate cancer. Watch his video to see how he coped.
Biological therapy drugs work in a number of ways including encouraging the body’s immune system to fight cancer cells.
Interferon can be used to treat advanced kidney cancer and is sometimes given along with bevacizumab (Avastin®).
Interferon is naturally produced by the body in small amounts and can also be made as a drug. It has different effects on the body’s immune system to help fight cancers.
The type 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). You, a relative or carer can be taught to give these injections at home. You can use either a pen-injection device or a pre-filled syringe, which makes it easier to give. If you need help your district nurse or GP practice nurse can give them to you.
In the first couple of weeks, interferon often causes flu-like symptoms such as chills, a high temperature, headaches, and aching in the back, joints and muscles. Your doctor can prescribe medicine, such as paracetamol, to reduce these symptoms. Another common side effect of interferon is feeling tired (fatigue).
Aldesleukin (Proleukin®), which used to be called interleukin-2 (IL-2), is an artificial version of a protein that occurs naturally in the body.
You’ll need to stay in hospital to have this treatment, which is given as a drip (intravenously) by a cancer doctor (oncologist). It may cause some serious side effects of the heart and lungs, so people having it are closely monitored.
Some common side effects of aldesleukin are flu-like symptoms, feeling sick or losing your appetite.