Find out about the latest UK research and clinical trials looking into kidney cancer.
All cancer treatments have to be fully researched before they can be used for everyone. This is so we can be sure that:
- they work
- they work better than the treatments already available
- they are known to be safe
The latest research into causes, prevention and treatment for kidney cancer is outlined below.
Kidney cancer research
Researchers are developing a test that can detect cancer cells in urine. This will help with diagnosing kidney cancer and monitoring how well treatment is working.
Researchers are looking at several genes that seem to change normal kidney cells into cancer cells.
Von Hippell Lindau gene
Scientists are looking at the von Hippell Lindau gene (vHL) to try to find out more about the process that leads to kidney cancer developing.
Particular faults in the vHL gene lead to very specific changes happening in kidney cells. The scientists are looking for these gene faults and finding out what they do. We hope that this work will lead to new treatments that block kidney cancer growth.
Recent research found that mutations in a gene called PBRM1 are present in up to a quarter of patients with renal cell carcinomas. This finding might help researchers develop tests and treatment in the future.
Photodynamic therapy (PDT) is an experimental treatment which uses a light activated drug.
Vascular targeted photodynamic therapy
Research is looking at treating small kidney tumours with vascular targeted photodynamic therapy (VTP).
This uses a light activated drug called WST 11, which you have through a drip into the vein. The doctor puts laser fibres into the tumour to activate the drug. This damages the blood vessels that feed the tumour and can shrink the tumour.
If research shows that it helps, future patients may be able to have PDT for small tumours instead of surgery.
HIFU stands for high intensity focused ultrasound. Strong beams of sound are directed precisely at cancer cells to kill them. Doctors think this might be an alternative to surgery for some people.
Trials have looked at HIFU before surgery, and when cancer cannot be removed by surgery. We need more research before we know whether if it is a helpful treatment for kidney cancer.
Biological therapies interfere with the way cells work. They can be used to:
- support your immune system to help fight off or kill cancer cells
- block signals telling cells to grow
Monoclonal antibodies are a type of biological therapy that target particular proteins on the surface of cancer cells. There are lots of monoclonal antibodies. These are some currently being researched for kidney cancer.
Nivolumab targets and blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking PD-1 activates the T-cells to kill cancer cells.
A clinical trial compared Nivolumab with another drug called everolimus. The researchers found that the average length of time people lived (overall survival) was around 5 months longer in the group who had nivolumab compared to the everolimus group (25 months compared to 19.6 months).
Ipililmumab works by stimulating the body's immune system to fight cancer cells.
A trial is comparing the combination of ipilimumab and nivolumab with another drug called sunitinib. We are waiting for the results of this trial.
Naptumomab estafenatox is also called ABR-217620 and is made up of 2 proteins. One protein recognises the cancer cells, and the other stimulates the body's immune system to attack them.
A trial tested naptumomab with interferon. People either had naputomab with interferon or just interferon.
Overall, the combined treatment did not help people to live longer than interferon alone. But in some people with particular types of tumour it did help them to live longer. So researchers want to carry out more studies to see if naptumomab could help patients with particular types of kidney cancer.
Many of the new biological therapy drugs are growth factor blockers. They are designed to stop cancer cells growing. Some of these drugs are known as tyrosine kinase inhibitors (TKIs).
Tyrosine kinases are a group of chemical messengers (enzymes) produced by body cells. They play a role in the way that cells grow and divide. A TKI drug blocks this process, which causes the cell to die. These are some TKIs being researched for kidney cancer.
Pazopanib blocks the kinases from sending signals to the cancer cells, causing the cells to die. Pazopanib can also stop the cancer cells from developing new blood vesssels. This reduces the supply of oxygen, making the tumour shrink or stop growing.
Pazopanib is used for advanced renal cancer. Trials are looking to see whether it helps to give Pazopanib before surgery.
Axitinib is a TKI that blocks the growth of new blood vessels. Research is looking at whether Axitinib can work for people with advanced kidney cancer.
Sorafenib stops signals that tell cancer cells to grow. It also stops cancer cells forming blood vessels.
Cabozantinib is another type of TKI. It targets 3 tyrosine kinases, so it’s called a multi kinase inhibitor.
Researchers from the METEOR trial have recently published some early results. This phase 3 trial compared cabozantinib with another type of biological therapy called everolimus for advanced kidney cancer. The people taking part had already had treatment with another TKI such as sunitinib.
The researchers found that the average length of time people lived without signs of their cancer getting worse (progression free survival) was longer for those having cabozantinib compared to everolimus (7.4 months compared to 3.8 months).
The researchers will continue to follow up the people taking part in the trial to see if cabozantinib helps people to live longer overall.
Other types of biological therapies have been researched for kidney cancer. These include drugs such as thalidomide that reduce the blood supply to tumours to stop them growing. Doctors call these types of drugs anti angiogenic treatments.
Anti angiogenic drugs being researched include Cediranib and Tasquinimod.
mTOR is a type of protein called a kinase protein. It can make cells produce chemicals such as cyclins that trigger cell growth. It may also make cells produce proteins that trigger the development of new blood vessels.
Cancers need new blood vessels in order to grow. In some types of cancer mTOR is switched on, which makes the cancer cells grow and produce new blood vessels. mTOR blockers (inhibitors) are a newer type of cancer growth blocker. They can stop the growth of some types of cancer.
Temsirolimus (Torisel) and Everolimus (Afinitor) are among the MTOR inhibitors being researched for kidney cancer.
Some renal cell cancers have large amounts of the growth factor receptors called EGFR and HER2. If the receptors are blocked, this can stop the cells from growing and dividing. A TKI drug called lapatinib (Tyverb) targets the receptors and has been tested in trials for advanced renal cell cancer. This research is still ongoing.
Cancer vaccines try to stimulate the body's own immune system to fight cancer.
The immune system naturally attacks foreign cells that are invading the body, such as bacteria and viruses. Because cancer develops originally from normal body cells, cancer cells are harder for the immune system to spot. So the patient’s immune system does not think that the cancer is foreign and does not try to get rid of it.
Vaccines stimulate the immune system to recognise and destroy cancer cells. Vaccine research in kdney cancer is still new, and is experiemental.
Chemotherapy does not work very well for the most common type of kidney cancer (renal cell cancer). But better treatment results have been gained by combining chemotherapy with other types of treatment such as biological therapies.
For renal cell cancer, trials are looking into combining chemotherapy and biological therapies.
New chemotherapy drugs are being developed all the time. And there are always clinical trials looking into these.
Different types of kidney cancer respond to different treatments. Chemotherapy is used more often for transitional cell cancer (TCC) than it is for renal cell cancer. Transitional cell cancer is a type of cancer that can develop anywhere in the urinary system – including the bladder, kidney or the tubes connecting them (the ureters).
Chemotherapy drugs that have been tested in transitional cell cancer include docetaxel (Taxotere), cisplatin and tretinoin.