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Immunotherapy in treating of kidney cancer // IKCC Great book of courage and hope

Insidious kidney cancer

The kidneys are filtering organs important for maintaining life. Their functions are, among others, elimination of toxins and metabolic waste, regulation of body electrolytes and water and hormone production. Kidney tumour is hazardous for proper functioning of the whole organism. Unfortunately our knowledge of its causes is still insufficient and the disease is often detected coincidentally.

Book of Courage and Hope

Kidney cancer causes and symptoms

Risk factors increasing chance of developing kidney cancer include obesity, hypertension, chronic use of diuretics and oral analgesics and tobacco smoking. It is estimated that even 30% of cancers may be related to tobacco smoking. Another presumable tumour causes are high-protein, rich in cholesterol diet and excessive coffee drinking.
Kidney cancer is an insidious tumour because at the beginning, even for a fairly long time, it has no symptoms. It is often detected coincidentally during ultrasound examination, computed tomography or magnetic resonance imaging. Only in the advanced stages its symptoms may include: periodical presence of blood in urine (not accompanied by pain), pain in the lumbar lower abdominal area or protrusion palpable through the abdominal wall. The disease may also present with general signs and symptoms such weight loss, lack of appetite, anaemia, fever, low or high blood pressure.

Kidney cancer treatment

Determination of kidney cancer stage enables accurate assessment of disease extent and planning further therapy. At the early stage of cancer, the most often chosen treatment approach is tumour resection. Surgery usually offers the best chances for recovery. When surgical treatment is not possible pharmacotherapy is used, yet it is more effective when used as adjuvant treatment. The latest treatment methods are immune-oncology therapies.
Immuno-oncology is a dynamically developing field of science combining two medicine sectors: immunology – science on human immune system structure and function, and oncology – science on aetiology, diagnosing and treatment of malignancies.
The main purpose of immune-oncology is to support human immune system to fight tumour. Immuno-oncology therapies provide long-term memory of immune system so they can constantly adjust to altering tumour biology. In that way, immune-oncology therapies offer an opportunity of long-term survival and good quality of life for patients with advanced malignancies who earlier had very low chances to survive.
A class of oncology immunotherapy anti-PD-1 drugs has been developed that prevent cancer cell hiding from the body immune system. Those PD-1 immune checkpoint inhibitors bind to T-cell PD-1 checkpoint receptors and block their function, thus preventing immune answer inhibition. An example of such drug is nivolumab that was registered and granted a marketing authorisation in April this year from the European Commission. Registration was based upon phase III CheckMate -025 trial results published in The New England Journal of Medicine. That study compared nivolumab to everolimus in patients with advanced clear cell RCC who previously received anti-angiogenic treatment. Treatment with nivolumab caused 25% improvement of patient’s survival.

Doctors consider kidney cancer as a rare neoplasm but patient population is still growing. Raising the awareness of causes, symptoms and possible treatments for that disease may have positive impact on decreasing morbidity rates and improve survival rates through early diagnosis. It should be kept in mind that the sooner the cancer is diagnosed and treated, the higher are patients’ chances for recovery.