Current Research

Research for kidney cancer is ongoing. The following advances may still be under investigation in clinical trials and may not be approved or available at this time. Always discuss all diagnostic and treatment options with your doctor.

Because most kidney cancers do not respond well to traditional chemotherapy, research for kidney cancer focuses on using new and different treatments, immunotherapy, and targeted therapy.

Targeted therapy. Several recently discovered drugs that affect the process of blood vessel development and/or cancer cell growth are being tested as treatments for kidney cancer. The early results from these clinical trials show that these types of drugs may be effective treatments for kidney cancer, and this is an area of rapid scientific change.

Axitunib (AG 013736) is still in clinical trials, but is showing that it may be an effective treatment for kidney cancer. Another anti-angiogenic drug approved by the FDA to treat colon, lung, and breast cancer, bevacizumab (Avastin), has been shown to slow tumor growth for people with metastatic renal carcinoma. Bevacizumab blocks VEGF, preventing a tumor from growing and spreading. A large study in the United States comparing interferon with interferon combined with bevacizumab was completed in July 2005, and a second study has also been completed in Europe. Both these studies show that bevacizumab combined with interferon slows tumor growth and spreading. However, neither clinical trial has shown that patients live longer when treated with bevacizumab.

A recent study has shown that adding the drug erlotinib (Tarceva) to bevacizumab caused kidney tumors to shrink for about 40% of patients. However, another clinical trial comparing bevacizumab alone with bevacizumab combined with erlotinib showed no benefit for adding erlotinib to bevacizumab.

Cancer vaccines. Cancer vaccines are treatments that help a person’s immune system fight cancer. Doctors are testing the use of several cancer vaccines to treat kidney cancer and prevent recurrence for people with advanced renal cell carcinoma. One vaccine is made from a person's tumor and given after surgery, while others are made from proteins found on the surface of kidney cancer cells or blood vessel cells found in the tumor.

Allogeneic (ALLO) stem cell transplantation or mini-transplant. A stem cell transplant is a medical procedure in which diseased bone marrow is replaced by highly specialized cells, called hematopoietic stem cells. Hematopoietic stem cells are found both in the bloodstream and in the bone marrow. In an ALLO transplant, stem cells are obtained from a donor whose tissue matches the patient’s on a genetic level; this testing is called HLA-typing. Most often, a patient’s brother or sister serves as the donor, although unrelated donors can serve as the donor too.

The goal of transplantation is to destroy cancer cells in the marrow, blood, and other parts of the body and have replacement blood stem cells create healthy bone marrow. In most stem cell transplants, the patient is treated with high doses of chemotherapy and/or radiation therapy to destroy as many cancer cells as possible. This also destroys the patient’s bone marrow tissue and suppresses the patient’s immune system so that the donor cells are not rejected by the body. After the high-dose treatment is given, blood stem cells are infused into the patient’s vein to replace the bone marrow and restore normal blood counts from donor cells. Sometimes, ALLO transplants can also be performed after giving lower doses of chemotherapy and/or radiation therapy that are still sufficient to suppress the immune system and allow growth of the donor cells. (These transplants, sometimes termed “mini-transplants” or “reduced intensity transplants” have less immediate side effects.

A major risk is that the donor’s cells will recognize the patient’s body as foreign, causing graft-versus-host disease (GVHD). GVHD may be a serious complication of allogeneic transplants and can be fatal. Other side effects may include liver problems, diarrhea, infections, and rashes. However, GVHD can also be a benefit, in that the donor cells can recognize the cancer cells as foreign and destroy these cells, a mechanism that is one of the major reasons why ALLO transplantation generally works so well over the long term. The risk of GVHD can be reduced with exact HLA-type matching and the use of preventative drugs.

Learn more by reading the Cancer.Net Feature series Understanding Bone Marrow and Stem Cell Transplantation.