Treatment for renal cell carcinoma is determined by the stage of the disease and the patient’s overall health.
Current treatments for renal cell carcinoma include nonsurgical treatments (cryoablation and radiofrequency ablation), surgery, arterial embolization, chemotherapy, radiation therapy, immunotherapy (biological therapy or biologics), and targeted therapy.
Non-Surgical treatments – Non-surgical treatments can be used in some patients with renal cell carcinoma to kill small tumors and include cryoablation (freezes cancer cells) and radiofrequency ablation (burns cancer cells).
Surgery – Types of surgery used for renal cell carcinoma may include partial nephrectomy (removal of the cancer and some of the surrounding tissue), simple nephrectomy (removal of only the kidney), radical nephrectomy (removal of the kidney, adrenal gland, surrounding tissue, and near lymph nodes), and kidney transplantation (removal of the diseased kidney and replacement with a donor kidney).
Arterial embolization – If the renal cell carcinoma cannot be removed with surgery (unresectable), then arterial embolization may be used to reduce the size of the tumor. In this procedure, a tube is inserted into the main blood vessel supplying the kidney and small pieces of gelatin sponge are inserted to block the blood flow and prevent the tumor from growing.
Chemotherapy – Chemotherapy uses drugs that kill cancer cells or stop them from growing and can be administered systemically via pill or intravenously (IV).
Radiation therapy – Radiation therapy for renal cell carcinoma uses directed or whole body high-energy X-rays or protons or other types of radiation to kill cancer cells or stop them from growing, and may also be used to help improve the patient’s quality of life by reducing or relieving symptoms (palliative therapy).
Immunotherapy (Biological therapy or Biologics) – Immunotherapy uses a patient’s immune system to kill the cancer or stop it from growing and includes immune checkpoint inhibitors, which block proteins on cancer cells to allow T cells (immune cells) to kill the cancer cells and are used for advanced renal cell cancer that cannot be removed by surgery (unresectable).
Immunotherapy drugs for renal cell carcinoma include ipilimumab (CTLA-4 inhibitor), nivolumab (Opdivo), pembrolizumab, and avelumab (PD-1 inhibitors), interferon (slows tumor growth), and interleukin-2 (boosts immune cells; IL-2).
Targeted therapy – Targeted therapy for renal cell carcinoma is often the first-line treatment for renal cell carcinoma and uses drugs that have been designed to target certain substances on cancer cells to kill them. Types of targeted therapy include antiangiogenic agents that stop tumor blood vessels from growing, monoclonal antibodies, and kinase inhibitors.
Monoclonal antibody therapy, such as bevacizumab (Avastin), is administered via infusion and uses antibodies from an immune cell designed in a lab that can kill cancer cells or stop them from growing or spreading (metastasis).
Kinase inhibitors, such as vascular endothelial growth factor (VEGF) and mTOR inhibitors, stop cancer cells or the blood vessels that supply tumors from growing, and include sunitinib (Sutent), pazopanib (Votrient), cabozantinib (CaboMetyx), axitinib (Inlyta), sorafenib (Nexavar; VEGF inhibitors) and everolimus (Afinitor) and temsirolimus (Torisel; mTOR inhibitors).
Some patients may also want to consider participating in clinical trials to gain access to new, experimental drugs for renal cell carcinoma.