Doctors at NYU Langone may prescribe a variety of medications to treat kidney cancer. They are usually used to manage advanced kidney cancer that has spread to other parts of the body, such as the lungs, bone, or liver.
NYU Langone is one of the only medical centers in the New York area to use high-dose immunotherapy. This is the one treatment that has been shown to lead to remission—meaning signs or symptoms disappear—in people with advanced kidney cancer.
Doctors treat kidney cancer with several targeted medications designed to home in on cancer cells while sparing healthy tissue. These therapies can often cause fewer side effects than other medications. Side effects that occur with targeted medications may include weakness, diarrhea, or mouth sores, among others.
Tyrosine Kinase Inhibitors
Tyrosine kinase inhibitors, a type of targeted medication, blocks the formation of new blood vessels that nourish and feed a kidney tumor and help it to grow. These medications also cause kidney tumors to shrink because they block substances that “tell” the cancer cells to grow and divide.
Targeted drugs—sunitinib is one example—are taken by mouth each day and are generally used for clear cell renal carcinoma, the most common subtype of kidney cancer, in which the cells look pale or almost clear under a microscope.
Another type of targeted medication, monoclonal antibodies help identify and destroy foreign substances in the body, such as bacteria and viruses. The antibodies attach to a protein on cancer cells, disrupting a tumor’s ability to produce new blood vessels. One of these drugs, bevacizumab, also known as Avastin®, has been shown to slow blood vessel growth in kidney cancer tumors.
Mechanistic Target of Rapamycin Inhibitors
Other targeted drugs work by blocking a protein called mechanistic target of rapamycin, or mTOR, which helps kidney cancer cells grow and divide. Doctors may prescribe these medications when other drugs, such as tyrosine kinase inhibitors, for example, no longer work. Mechanistic target of rapamycin inhibitors are either taken by mouth every day or given through a vein with intravenous (IV) infusion about once a week.
Although these medications can often shrink kidney tumors, the response may not last.
Immunotherapy boosts the body’s immune response to cancer. These medications are used to treat advanced kidney cancers and can result in remission, meaning the signs and symptoms of the cancer disappear for months or years.
One of these medications, interleukin 2, is given through a vein with intravenous (IV) infusion for about 15 minutes, every 8 hours, for several days. This process may be repeated several times. This is done in the hospital, where a doctor can watch for potential side effects, such as low blood pressure and fluid in the lungs, and adjust the dose.
Kidney cancer is not often responsive to chemotherapy, a group of drugs that destroy cancer cells throughout the body. However, NYU Langone doctors may sometimes use the drugs for rapidly growing tumors or non-clear cell kidney cancer.
Chemotherapy drugs are often given through a vein with IV infusion for a few hours a day, several days a week, every three or four weeks. Having several weeks off between treatments gives the body a chance to rest and recover from the effects of the medications. This cycle is then repeated several times. Other chemotherapy drugs can be taken by mouth, usually on a daily basis.
Managing Side Effects
Side effects of targeted drugs include fatigue, nausea, rash, and diarrhea, while chemotherapy may cause nausea, vomiting, and fatigue. Doctors can manage these side effects by adjusting the dose, prescribing other medications, or referring you to integrative health services, which can assist you in other ways.
The side effects of immunotherapy may include bleeding, infection, low blood pressure, and fluid in the lungs. Doctors manage these effects in the hospital.
NYU Langone researchers are investigating combinations of medications that can be given after kidney cancer surgery to prevent the condition from returning. They are also investigating new approaches to immunotherapy in a multicenter trial. Clinical trials of medications are available for people with advanced kidney cancer that has spread throughout the body.