Kidney cancer is known to be the most lethal cancer type affecting the urinary tract. The reports have revealed that kidney cancer has been estimated with an annual incidence of more than 300,000 new cases and more than 140,000 cases of mortality across the globe. Most of the patients have been diagnosed with renal cell carcinoma and renal pelvis carcinoma, which is a type of kidney cancer. The five-year survival rate for kidney cancer patients is estimated to be 68%. Although early stage diagnosis resulted as a cure for the disease, still metastatic kidney cancer is known to be a lethal disease. It is mainly considered to be “silent” as it is not observable with any symptoms until it shows metastasis to other body parts.
If we go back before 20 years, no advancements were available for treating patients with kidney cancer, as the patients were traditionally resistant to chemotherapy and older forms of radiation therapy. But in the modern era, several techniques are available for the treatment of advanced stages of kidney cancer. Today we are equipped with several treatment approaches that we didn’t have in the past and which eventually led major impact on the improved survival rate of the patients. The median survival for patients with advanced kidney cancer found 15 years ago was just over a year, but the modern era has shown a median survival of four years among patients with advanced kidney cancer.
The treatment options have grown in number, resulting in better health outcomes for patients. Different molecular agents have been approved for using it as a treatment agent in many countries as per the patients’ feedback. Hence, advancements in the treatment approach of treating cancer patients have been proven to be effective while reducing the morbidity and mortality rates.
One of the most important treatments for advanced kidney cancer includes systemic medical treatment, which integrates the use of immunotherapy. According to the results of real-world studies presented at IKCS Europe 2022, this will increase overall survival. Clinical trials have been conducted that result in showing the efficacy of the treatment options when compared with the use of sunitinib in kidney cancer treatment. The use of cabozantinib for metastatic papillary kidney cancer and lenvatinib or pembrolizumab for renal cell carcinoma is suggested in kidney cancer treatment. Visit Manipal Hospitals for Kidney cancer treatment in Mangalore.
Another study shows the fact that metastatic papillary kidney cancer when treated with the small molecule inhibitor cabozantinib showed a long-term progression-free survival when compared with the current standard of care (SOC), sunitinib, known as the receptor tyrosine inhibitor. A randomised controlled trial was conducted with the inclusion of 147 patients who received either sunitinib or one of the three MET gene targeting drugs involving cabozantinib, crizotinib, and savolitinib. Patients receiving savolitinib and crizotinib did not show effective results when compared with those patients who received the current standard of care (SOC). On the other hand, patients receiving cabozantinib showed inhibition of VEGF receptors and AXL, providing the patients with a median of 9.2 months before their cancer progressed. Also, tumour reduction was observed among 23% of the patients who were treated with cabozantinib, while only 4% of the patients with SOC showed tumour reduction.
The combination of immunotherapy and targeted drug therapy has shown efficacy in improving the survival rate of patients suffering from advanced kidney cancer. Phase III clinical trials have been conducted among patients with renal cell carcinoma (RCC) who have received a targeted drug in combination with a checkpoint-blocker immunotherapy agent. The results showed a prolonged survival rate when compared with the patients treated with SOC sunitinib. This combined treatment is considered the first-line treatment for patients suffering from advanced renal cell carcinoma. A randomised clinical trial was conducted involving patients who were treated with SOC, lenvatinib/pembrolizumab, or lenvatinib/everolimus. The groups of patients treated with lenvatinib combinations showed prolonged progression-free survival when compared with the ones who received sunitinib. The patients undergoing treatment with lenvatinib and pembrolizumab boost their immune systems to attack the cancer cells. Consult with our Surgical Oncologist in Mangalore to know more about the treatment procedures.
Advancement in the treatment of kidney cancer is the visualization of PD-L1, a protein that controls the body’s immune response helps in the identification of kidney cancers when used with immunotherapy treatments. The use of glutaminase inhibitor and interleukin-2, a modified form of a drug are being tested in clinical trials. A phase III clinical trial is on-going for the new drug, MK-6482, which is known as the first-in-class single agent, responsible for blocking blood-vessel growth by targeting another protein in the angiogenesis pathway. It is predicted that in the coming future, new biomarkers will be discovered for determining better treatment approach to be used for the specific patients.
Although there is increasing progress on-going in the treatment of kidney cancer, still the demand of fulfilling the unmet clinical needs in the diagnosis and treatment persists, looking forwards towards more advancement in the treatment approaches.
Consultant - Surgical Oncologist
Manipal Hospitals, Mangalore
