Treatment for advanced kidney cancer may involve a combination of immunotherapy and targeted therapy medications. These can shrink a tumor, slow its growth, or reduce the risk of cancer returning.

Treatment in the early stages of kidney cancer commonly involves surgery or a nonsurgical option called thermal ablation.

If your kidney cancer is advanced and has spread to other parts of the body, or if it has a high risk of coming back, your doctor may recommend medications along with surgery or instead of surgery.

What medication your doctor prescribes often depends on the type of kidney cancer you have. Over 90% of kidney cancers are classified as renal cell carcinoma (RCC). Other less common cell types include Wilms tumors and transitional cell carcinoma.

Other factors doctors consider in prescribing medication for kidney cancer include:

This article reviews the medications a doctor may consider as part of your kidney cancer treatment.

Unlike other types of cancer, chemotherapy isn’t usually effective for most forms of advanced kidney cancer. Instead, your doctor will likely prescribe medications called targeted therapy or immunotherapy.

Doctors typically follow practice guidelines from the National Comprehensive Cancer Network (NCCN), a cancer care nonprofit, for guidance on which medications will most likely work best for each type of cancer.

Immunotherapy medications help your body’s immune system more effectively recognize and eliminate cancer cells.

For advanced kidney cancer, researchers have identified a class of drugs known as immune checkpoint inhibitors. They work by blocking certain proteins in immune system cells called T cells. This, in turn, helps boost your body’s natural immune response against cancer.

Immune checkpoint inhibitors include:

Some people may receive interleukin-2 (IL-2) to treat kidney cancer that has spread. This was one of the earliest immunotherapy options for kidney cancer. Although it is very effective, its use is restricted to people with good organ function because it can cause severe side effects.

Your medical team administers these medications by intravenous (IV) infusion.

Like IL-2, interferon alpha was another early immunotherapy treatment for kidney cancer. Although doctors can use it on its own, they often use it alongside bevacizumab, a targeted therapy, for better results. You take interferon alpha by an injection under your skin.

Targeted drugs target the changes in cells that cause cancer. Unlike chemotherapy drugs, targeted drugs limit damage to healthy cells, which means they usually cause fewer side effects.

Research shows that medications known as tyrosine kinase inhibitors (TKIs) can shrink or slow the growth of kidney tumors. Examples of TKIs include:

For certain subsets of kidney cancer, doctors may also use medications that target other proteins, such as:

  • bevacizumab (Avastin), which targets vascular endothelial growth factor (VEGF)
  • everolimus (Afinitor), which targets rapamycin (mTOR)

You typically take targeted therapies as a pill by mouth once or twice a day.

Chemotherapy is a cancer treatment that targets and destroys rapidly growing cells, like cancer cells. Chemotherapy isn’t very effective at treating most kidney cancers. Still, doctors might use it alongside other medications or if other therapies don’t work.

Some rarer types of kidney cancer, like Wilms tumor and transitional cell carcinoma, may respond better to chemotherapy.

You can receive chemotherapy by IV or as pills. Examples include:

What is the best drug for kidney cancer?

Treatments for kidney cancer are constantly improving and progressing as scientists learn new information.

Currently, the NCCN recommends combining a TKI and a checkpoint inhibitor as a first-line treatment for advanced RCC. Examples include:

  • Inlyta plus Keytruda
  • Cabometyx plus Opdivo
  • Lenvima plus Keytruda

Research suggests the combination of targeted therapy and immunotherapy improves survival compared with targeted therapy alone.

Upper tract urothelial cancer (UTUC), also known as transitional cell carcinoma, is an uncommon cancer. It forms in the inner lining of the tube that connects your kidney and bladder (ureter) or where urine collects in the kidneys before it travels to your bladder (renal pelvis).

Medications approved to treat UTUC include:

Certain immune checkpoint inhibitors may also be used to treat UTUC. These include:

  • pembrolizumab (Keytruda)
  • nivolumab (Opdivo)
  • atezolizumab (Tecentriq)
  • avelumab (Bavencio)
  • durvalumab (Imfinzi)

Wilms tumor is a type of kidney cancer that mainly affects children. Unlike RCC, Wilms tumor often responds better to treatment with chemotherapy and radiation.

Chemotherapy medications to treat Wilms tumor include:

  • doxorubicin
  • dactinomycin
  • vincristine sulfate
  • carboplatin
  • cyclophosphamide
  • etoposide

Experts consider the introduction of immunotherapies to treat kidney cancer a medical breakthrough. Combining immunotherapy and targeted therapy has drastically improved success rates for treating advanced kidney cancer compared with targeted therapy alone.

Many recent clinical trials compared combination treatments with Sutent, a TKI medication previously considered the standard of care for advanced kidney cancer.

For example, 3-year follow-up data from a clinical trial evaluating a combination of Opdivo and Cabometyx showed an improvement in median overall survival of 49.5 months compared with 35.5 months for Sutent in people with advanced kidney cancer.

Can medications alone cure kidney cancer?

Targeted and immune therapies can shrink or slow the growth of kidney tumors, but they probably can’t get rid of them completely.

Surgery is usually the most common treatment for eliminating kidney cancer that hasn’t spread. The survival rate for RCC depends on how far it has spread, so early detection is critical.

Common side effects of immunotherapy and targeted therapy include:

More serious side effects may include:

Many people living with cancer experience anxiety or depression. You may also become stressed about the effects on your job, relationships, and quality of life.

Your cancer care team is there to help guide you through treatment and answer any questions that may arise during and after treatment. Your team will likely include many healthcare professionals, like:

Reaching out to your care team can help you navigate these issues. They can recommend palliative care (also known as supportive care) to help improve your quality of life during treatment.

Resources for support

Consider contacting these organizations for support:

Though surgery is the primary treatment for early stage kidney cancer, doctors more commonly use targeted and immunotherapy medications in advanced stages.

Doctors may also use medications if there’s a high risk your cancer could come back after surgery.