Drug Therapy Options for Advanced Kidney Cancer
The next treatment step: cancer medications
After you and your doctor have discussed surgery, you will talk about the next step of your treatment journey. This step may be cancer medicine.
There are several things to think about when choosing the first medicine that you will take on your treatment journey. Different medicines are appropriate for different patients, work in different ways, and have different side effects. Everyone reacts differently to the same medicines so your doctor will not be able to predict exactly what your experience will be. Be sure to ask your doctor about the side effects of the drugs he or she recommends so that you know what to expect. Remember, some people are not bothered as much by certain side effects as others.
Another factor in your decision making will be whether you and your doctor think an oral or an intravenous (IV) medicine is appropriate for you.
- Oral medications are pills that you can take by mouth at home
- Intravenous (IV) medications are given through your vein. You have to go to your doctor's office to receive them
Many drugs for advanced kidney cancer are taken orally. This eliminates the need to receive treatment in your doctor's office.
Understanding your advanced kidney cancer medication options
When surgery alone is not enough to control kidney cancer, doctors may recommend specific kinds of medicine to fight the disease. Today, there are a number of different treatments available to treat advanced kidney cancer. In fact, over the past decade, there have been a number of exciting advances in the treatment of advanced kidney cancer.
When going over your advanced kidney cancer treatment options, you and your doctor will decide which medication is right for you. Some medicines can be used at any point in your treatment journey, while others cannot. Some of them are taken orally, and some of them are given as IV medicines in your doctor's office. Whichever medicine you and your doctor chose for you to take on your treatment journey, be sure to take it exactly as your doctor tells you to.
Treatment with cytokines
Cytokines work by helping the body's immune system fight cancer cells. These medicines have been available for a long time and are not used as much as they once were. Some have shown to be less effective than some of the newer therapies available, though they may be used in combination with newer therapies. Others, while they do offer a small chance of remission, are associated with potentially serious adverse events and are usually reserved for select patients. The most common side effects are low blood pressure, diarrhea, chills, and vomiting.
Treatment with anti-VEGF therapies
Anti-VEGF therapies get their name because they target a protein called VEGF. VEGF can make blood vessels grow toward the tumor. Blocking VEGF helps keep the tumor from getting the blood supply it needs to grow and spread. Three available medicines are taken orally and one is given as an infusion. The most common side effects include fatigue, diarrhea, rash, and nausea.
Treatment with mTOR inhibitors
mTOR inhibitors target a protein called mTOR, which is different from VEGF. They directly affect both the cancer cells and the blood vessels that feed them, which may make it harder for tumors to grow and spread. Currently, two mTOR inhibitors have been approved for advanced renal cell carcinoma. One is taken orally and the other is given as an infusion in the doctor's office. AFINITOR can cause serious side effects including lung or breathing problems, infections, and kidney failure, which can lead to death. Mouth ulcers and mouth sores are common side effects. AFINITOR can affect blood cell counts, kidney and liver function, and blood sugar and cholesterol levels. Regular blood tests should be performed before starting AFINITOR and as needed during treatment to check blood cell count, kidney and liver function, and blood sugar levels.
To learn about Afinitor as a treatment option, click here.
Reviewing your advanced kidney cancer treatment options
It's a good idea to discuss the pros and cons of all of your treatment options with your doctor so that, together, you can make an educated decision about your renal cell carcinoma treatment. Whichever medicine you decide to take on your treatment journey, be sure to take it exactly as your doctor tells you to.
Keep track of your advanced
kidney cancer treatment
Afinitor is a prescription medicine used to treat people with advanced kidney cancer (renal cell carcinoma or RCC) when certain other medicines have not worked (ie, Sutent® [sunitinib] or Nexavar® [sorafenib]).
Important Safety Information
Patients should not take AFINITOR if they are allergic to AFINITOR or to any of its ingredients. Patients should tell their healthcare provider before taking AFINITOR if they are allergic to sirolimus (Rapamune®) or temsirolimus (Torisel®).
AFINITOR can cause serious side effects including lung or breathing problems, infections and kidney failure, which can even lead to death. If patients experience these side effects, they may need to stop taking AFINITOR for a while or use a lower dose. Patients should follow their healthcare provider's instructions.
Lung or Breathing Problems: In some patients, lung or breathing problems may be severe, and can even lead to death. Patients should tell their healthcare provider right away if they have any of these symptoms: new or worsening cough, shortness of breath, chest pain, difficulty breathing or wheezing.
Infections: AFINITOR may make patients more likely to develop an infection, such as pneumonia, or a bacterial, fungal, or viral infection. Viral infections may include reactivation of hepatitis B in people who have had hepatitis B in the past. In some people these infections may be severe, and can even lead to death. Patients may need to be treated as soon as possible. Patients should tell their healthcare provider right away if they have a temperature of 100.5°F or above, chills, or do not feel well. Symptoms of hepatitis B or infection may include the following: fever, skin rash, joint pain and inflammation, tiredness, loss of appetite, nausea, pale stool or dark urine, yellowing of the skin, or pain in the upper right side.
Kidney Failure: AFINITOR may cause kidney failure. In some people this may be severe and can even lead to death. Patients should have tests to check their kidney function before and during their treatment with AFINITOR.
Mouth Ulcers: AFINITOR can cause mouth ulcers and sores. Patients should tell their healthcare provider if they have pain, discomfort, or open sores in their mouth. Their healthcare provider may tell them to use a special mouthwash or mouth gel that does not contain alcohol or peroxide.
Blood Tests: Patients will have regular blood tests before they start AFINITOR and as needed during their treatment. These will include tests to check the patient's blood cell count, kidney and liver function, and blood sugar levels.
Other Medicines/Food and AFINITOR: AFINITOR may affect the way other medicines work, and other medicines can affect how AFINITOR works. Using AFINITOR with other medicines can cause serious side effects. Patients should tell their healthcare provider about all of the medicines they take, including prescription and non-prescription medicines, vitamins, and herbal supplements such as: St. John's Wort and medicine for fungal infections, bacterial infections, tuberculosis, seizures, HIV-AIDS, heart conditions or high blood pressure, and medicines that suppress their immune system. Patients should not drink grapefruit juice or eat grapefruit during their treatment with AFINITOR as it may make the amount of AFINITOR in their blood increase to a harmful level.
Patients should not take AFINITOR tablets which are broken or crushed. Patients should not chew or crush the tablets.
Liver Problems and Other Medical Conditions: The amount of AFINITOR in the blood was increased in patients who had liver problems. Patients should tell their healthcare provider about all their medical conditions including if they have or have had liver problems, diabetes or high blood sugar, high cholesterol levels, infections, hepatitis B, or other medical conditions.
Vaccinations: Patients should tell their healthcare provider if they are scheduled to receive any vaccinations. Patients should not receive a live vaccine or be around people who have recently received a live vaccine during treatment with AFINITOR.
Use in Pregnancy: It is not known if AFINITOR will harm an unborn baby. Women should use effective birth control while using AFINITOR and for 8 weeks after stopping treatment.
Common Side Effects: Common side effects of AFINITOR include mouth ulcers; feeling weak or tired; cough and shortness of breath; diarrhea; skin problems (such as rash, dry skin, and itching); nausea and vomiting; fever; loss of appetite; swelling of arms, hands, feet, ankles, face or other parts of the body; abnormal taste; inflammation of lining of the digestive system; headache; nose bleeds; and pain in arms and legs.
Patients should tell their healthcare provider if they have any side effect that bothers them or does not go away.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Full Prescribing Information for AFINITOR
Sutent®, Rapamune® and Torisel® are registered trademarks of Pfizer Inc.
Nexavar® is a registered trademark of Onyx Pharmaceuticals, Inc. and Bayer HealthCare Pharmaceuticals, Inc.
