Targeted and immunotherapy drugs for advanced kidney cancer

Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. They are called immunotherapies.

Some drugs work in more than one way. So they are targeted as well as working with the immune system. 

Why you might have them

These drugs are used to try to control advanced kidney cancer. They may stop or slow the growth of your cancer for months, and sometimes years.

Different treatments work for different people. Your doctor will look at a number of factors to decide which treatment is best for you. This includes: 

• the type of kidney cancer (the type of cells the cancer started in)
• how abnormal the cells look (grade) and whether it is a slow growing or fast growing cancer
• the size of your cancer and extent of the spread
• your symptoms
• your general health

First treatment

Your first treatment for advanced cancer is called first line treatment. You might have one of the following:

• sunitinib (Sutent) 
• pazopanib (Votrient) 
• tivozanib (Fotivda)
• avelumab (Bavencio) and axitinib (Inlyta)
• nivolumab (Opdivo) with ipilimumab (Yervoy)
• cabozantinib (Cabometyz or Cometriq)
• lenvatinib (Kisplyx) with pembrolizumab (Keytruda)

The Scottish Medicines Consortium (SMC) has recently approved cabozantinib with nivolumab for use within NHS Scotland for the first line treatment of advanced kidney cancer.

Some people might have high doses of aldesleukin (interleukin 2 or Proleukin). This immunotherapy treatment is quite specialised and so you might need to travel to another hospital to have this.

If your treatment stops working

If the cancer starts growing again, your doctor may recommend another treatment. This is called second line treatment.

Your treatment might include one of the drugs above. Or you may have one of the following:

• axitinib
• lenvatinib and everolimus

Clinical Trials

Researchers are developing and testing new types of targeted drugs and immunotherapies. They are also looking at combining these in different ways to find the best treatment.

You may be offered these treatments as part of a clinical trial.