How New Treatments Are Changing the Future of Kidney Cancer

March marks Kidney Cancer Awareness Month, a time to spotlight advances that are helping patients live longer and maintain quality of life. CURE recently spoke with Dr. Eric Singer, a medical oncologist and urologic surgeon, about how treatment for advanced kidney cancer has evolved over the past two decades.

Singer reflects on a pivotal moment late 2005/early 2006, when the first targeted therapies were approved, ushering in the tyrosine kinase inhibitor (TKI) era and moving the needle in kidney cancer care.

Since then, the field has progressed into the immunotherapy era, with combination approaches now standard for many patients. Singer highlights emerging strategies in care and emphasizes that these advances are transforming patient outcomes while preserving quality of life.

Singer also serves as chief of the Division of Urologic Oncology here at the OSUCCC – James, director of the Urologic Oncology Fellowship Program, co-director of the Genitourinary Disease-Specific Research Group, as well professor, the Department of Urology and in the Division of Bioethics at The Ohio State University College of Medicine.

Transcript

What treatment advances in kidney cancer are helping people live longer and maintain that quality of life?

I remember in December 2005 and January 2006 when the first targeted therapies, Nexavar (sorafenib) and Sutent (sunitinib), were approved for advanced kidney cancer. That really ushered us from the era of cytokine therapy, where we would use high-dose interleukin-2 or interferon, into the TKI era. We have since moved through those therapies and are now in the immunotherapy era, where we are combining drugs for patients who have advanced kidney cancer.

We are either using two immunotherapy drugs or one immunotherapy drug and one targeted therapy, and those have been a huge advance. I think one of the things we are really excited about right now is how we can combine therapies to treat both distant disease (cancer outside the kidney that may have spread to other places) and the primary tumor in the kidney itself.

We just completed a study called CYTOKICK, where we used immunotherapy plus targeted therapy for three months followed by cytoreductive surgery. We then removed the primary tumor in patients who had cancer that had spread elsewhere and treated them with more medicine after surgery, utilizing a perioperative approach instead of just giving medicine either before or after surgery.

As we increase our understanding of how kidney cancer and its different types work, we are able to combine treatments in new orders and combinations. There is a lot of exciting data on new drugs like HIF inhibitors…

We want to ensure we are providing good cancer care. We want to maximize quality of life and be aggressive in our management of side effects from both the treatments we provide and the disease itself. Finally, we want to ensure we are referring patients to high-volume centers with high-volume providers, as that has been shown to provide the best benefit and outcomes for kidney cancer patients.

References

1. Sorafenib for the treatment of advanced renal cell carcinoma, by Dr. Robert C Kane, et al. Clinical Cancer Research.
2. Approval summary: sunitinib for the treatment of imatinib refractory or intolerant gastrointestinal stromal tumors and advanced renal cell carcinoma, by Dr. Vicki L Goodman, et al. Clinical Cancer Research.

Transcript has been edited for clarity and conciseness.

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