Immunotherapy’s ability to unlock and boost your body’s immune defenses holds promise for several cancers. One of them is cancer of the kidney, or renal cell carcinoma.
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“In various ways, immunotherapy drugs allow a kidney cancer patient’s immune system to work better to fight the tumor,” says Brian Rini, MD, a genitourinary cancer specialist. This allows some patients to live longer.
How your immune system works
Your immune system’s molecules, cells and organ are the body’s first line of defense against infection and disease.
In essence, your immune system’s job is to keep you healthy by distinguishing normal cells from foreign cells. When it encounters foreign cells — such as bacteria, viruses or parasites — your immune system launches an attack.
At the same time, key molecules serve as “immune checkpoints,” shielding normal tissue from damage by blocking certain molecules and activating others.
Yet some cancer cells can find workarounds, slipping past your immune defenses, or hiding from them and surviving — only to show up later.
How immunotherapy is used
Traditional cancer treatments focus on killing cancer cells or halting their growth, but may damage healthy cells inadvertently.
Thus, researchers are exploring different ways to harness the immune system to better recognize, fight and destroy cancer cells while minimizing damage to other cells.
For example, they have developed and continue to investigate several immune checkpoint inhibitors to treat kidney cancer. Researchers are also studying how to help the immune system remember cancer cells in case they come back, says Dr. Rini.
In kidney cancer, immunotherapy is typically combined with traditional treatments such as surgery and chemotherapy. However, each patient’s treatment is individualized, depending on the stage of the cancer, how fast it is growing and other factors.
Potential side effects of immunotherapy
Heightened immune system activity can sometimes lead to inflammation in normal organs.
“As a result, the most common side effects of immunotherapy involve inflammation in the form of a rash on the skin, diarrhea in the gut and abnormal liver function,” says Dr. Rini.
Other side effects include fatigue; nausea and loss of appetite; constipation; and joint pain.
Your cancer care team will watch for any ill effects from immunotherapy. “We can usually control side effects and generally start with steroids as an initial step,” he says.
However, inflammation can at times become severe and even life-threatening.
The way of the future
“Immune-based regimens will become the standard of care for kidney cancer and many other diseases in the near future,” Dr. Rini predicts.
He and other kidney cancer experts expect it to develop as the mainstay of initial treatment.