Strategies to Improve Treatment for Stage IV Kidney (Renal Cell) Cancer

This content has been reviewed and approved by

Robert J. Motzer, MD
Attending Physician

Memorial Sloan-Kettering Cancer Center
 

Researchers are currently investigating new treatments for stage IV kidney cancer. The development of better treatments depends on clinical trial participation. If you wish to participate in a clinical trial, talk to your doctor about the types of trials available, and the potential benefits and side effects of any treatment you may receive.

Targeted Therapies

Targeted therapies are medications that block or attack specific cell processes that the kidney cancer cells need to survive and grow. These therapies are developed based on a detailed knowledge of the cell biology of kidney cancer. Sutent® (sunitinib), Nexavar® (sorafenib), Avastin (bevacizumab), Afinitor (everolimus) and Torisel™ (temsirolimus) are approved in the United States for use in renal cell cancer.

  • Sunitinib and sorafenib may stop or slow down the progression of renal cell cancer, at least temporarily. Both agents are being studied alone and in combination with biologic modifier therapy as treatments for stage IV renal cell cancer. Temsirolimus has been shown to improve survival compared with alpha interferon and to stop or slow down, at least temporarily, cancer progression in patients with stage IV or recurrent (returning) renal cell cancer. Like all powerful drugs against cancer, it has side effects and necessary precautions that you should review with your doctor if this treatment is under consideration.

    On July 31, 2009, the FDA granted approval for the use of Bevacizumab (Avastin®, made by Genentech, Inc.) in combination with interferon alfa for the treatment of patients with metastatic renal cell carcinoma. The approval was based demonstration of a 5-month improvement in median progression-free survival (PFS) in patients treated with bevacizumab.

Afinitor (everolimus) is indicated for the treatment of patients with advanced renal cell cancer who have not responded to treatment with sunitinib or sorafenib. This drug targets tumor cells and blood vessel cells. In the trial which led to the approval of this drug, half the patients had a progression-free survival of 4.9 months with Afinitor vs 1.9 months with placebo.

Biologic Modifier Therapy

Biologic response modifiers are naturally occurring or created substances that direct or help your body's normal immune defenses. The goal of biologic therapy is to get your immune system to launch an attack on cancer cells.

Biologic response modifiers include:

  • Interleukins - substances that stimulate certain kinds of white blood cells to grow

    • Proleukin® (aldesleukin) - Aldesleukin is a biologic response modifier approved for the treatment of advanced renal cell cancer, and a commercial form of interleukin-2. Clinical trials showed that aldesleukin achieved a long-standing response in 5 percent of patients with advanced renal cancer.

  • Monoclonal (laboratory-created) antibodies - disease-fighting elements of your immune system.
  • Interferons - substances that the body produces naturally to help fight infections and tumors

    • Alpha interferon (also known as interferon-alpha) - a mixture of substances imitating the structure and action of natural interferon. Alpha interferon may help the body recognize and destroy other types of cancer cells, but is associated with severe side effects.

     

This content was last reviewed August 15, 2010 by Dr. Reshma L. Mahtani.
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