Biologic therapy may be used in the treatment of kidney cancer that has spread.
Biologic therapy is a treatment that uses drugs to improve the way your body’s immune system fights disease. Your immune system is your body’s natural defense against disease. Biologic therapy attempts to repair, stimulate, or enhance the immune system so that it can fight the cancer more effectively. These therapies can be used to fight cancer or to lessen the side effects that may be caused by some cancer treatments.
Examples of agents used to treat kidney cancer include interferon and interleukin 2 (also known as IL-2, aldesleukin, or proleukin). Doctors are investigating using interferons with other biologic agents.
Interleukin 2 (IL-2) is approved for metastatic kidney cancer, when the disease has spread to other places in the body. The medicine is given either subcutaneously (shots under the skin) or intravenously (by vein) either in the hospital or in an outpatient setting. Treatment may be given in cycles separated by a rest period. Although only about one in six patients with renal cell carcinoma have shrinkage of their cancer with IL-2, some of these patients have disappearance of their cancer (complete remission) that can be long-lasting. Unfortunately, the medicine has many side effects and is not appropriate for all patients with renal cell carcinoma.
A combination treatment of bevacizumab (Avastin) and interferon-alpha is used for patients with kidney cancer that has spread to other parts of the body. The medicines are given intravenously and work by preventing the growth of new blood vessels to the tumor. The drugs were approved after clinical trials showed an increase of five months in survival rate versus interferon-alpha alone. Tumor size also decreased 30% with the combination medicines, versus 12% with interferon-alpha alone. The most common side effects are hypertension and gastrointestinal bleeding or perforation.
Interleukin 2 produces responses in 15% of kidney cancer patients. Interferon response rate is about 15%. The combination of interferon with other chemotherapy drugs and IL-2 increases the response rate.
Research shows adverse events occur in the majority of patients. The percentages of people experiencing common adverse events of IL-2 are as follows:
- Chills: 52%
- Fever: 29%
- Low blood pressure: 71%
- Diarrhea : 67%
- Vomiting: 50%
- Rash: 42%
- Shortness of breath: 43%
Side effects for the bevacizumab and interferon alpha combination included:
- Protein in the urine
- High blood pressure
This new class of medicines attempts to interfere with the growth of the tumor by blocking the formation of new blood vessels around the tumor. In recent months, this drug has received FDA approval.
Sorafenib (Nexavar) is a new medicine that targets several different pathways of tumor growth. The most common side effects seen with this drug include:
- Blisters on the palms of the hands or soles of the feet
- Nerve damage
This medicine is given in the form of a pill.
Taken in pill form, sunitinib (Sutent) attacks both blood vessel growth and other targets that stimulate cancer cell growth. The results show tumor shrinkage in one third of the patients treated. The most common side effects are diarrhea, change in skin color, mouth irritation, weakness, and altered taste. Other possible effects include tiredness, hypertension, bleeding, and hypothyroidism .
Temsirolimus (Torisel) is an intravenous medicine used in advanced kidney cancer, which also works to inhibit cell growth. The most common side effects include:
- Skin rash
- Feeling weak
- Mouth irritation
- Loss of appetite
- Fluid buildup in the face or legs
- Increases in blood sugar and cholesterol levels
Pazopanib (Votrient) is approved for the treatment of advanced kidney cancer. It is taken once a day as a pill either an hour before eating or two hours after eating. It works by preventing the growth of new blood vessels to tumors. The most common side effects include:
- Reviewer: Mohei Abouzied, MD
- Review Date: 09/2012 -
- Update Date: 00/93/2012 -