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Immunotherapy for Kidney Cancer
Immunotherapy is the use of medicines to boost your own immune system so it can recognize and destroy cancer cells more effectively. Immunotherapy drugs have different side effects than chemotherapy drugs.
Several types of immunotherapy can be used to treat kidney cancer.
Immune checkpoint inhibitors for kidney cancer
Just as it’s important that immune cells get activated to fight infections and cancer, it’s also important that they turn off when they are no longer needed.
Checkpoint proteins on immune cells act as brakes to slow down immune attacks. Cancer cells sometimes use these checkpoints to keep from being attacked by the immune system.
Drugs that target these checkpoint proteins are called immune checkpoint inhibitors. They can help restore the immune response against cancer cells.
PD-1 and PD-L1 inhibitors
By blocking either of these checkpoint proteins, these drugs boost the body’s immune response against kidney cancer cells. This can often shrink tumors or slow their growth.
These drugs are given by infusion into a vein (IV), typically once every 2 to 6 weeks, depending on the drug. Some are available as an injection under the skin (subcutaneous).
These drugs target PD-1. PD-1 is a protein on immune system cells called T cells. It normally helps keep T cells from attacking other cells in the body.
This drug targets PD-L1, which is a protein that binds to PD-1. PD-L1 is found on some tumor cells and immune cells.
How PD-1 and PD-L1 inhibitors are used to treat kidney cancer
These drugs can be used in a few different situations to treat kidney cancer.
As adjuvant treatment (after surgery):
- Pembrolizumab can be given after surgery in people who are at higher risk of their cancer coming back, to help lower this risk. It is usually given for about a year after surgery, either alone or with a targeted drug called belzutifan (Welireg).
For advanced kidney cancer:
- One of these drugs is often part of the first treatment for advanced kidney cancer, along with a targeted drug or with the CTLA-4 inhibitor ipilimumab (see below).
- One of these drugs can also be used if advanced kidney cancer starts growing again after other drug treatments have been tried. It might be given alone or with another type of drug.
Possible side effects of PD-1 and PD-L1 inhibitors
The most common side effects include:
- Fatigue (feeling tired)
- Cough
- Nausea
- Itching
- Skin rash
- Loss of appetite
- Constipation
- Joint pain
- Diarrhea
These drugs can also have more serious side effects, although it’s not common. See below for possible severe side effects of all checkpoint inhibitors.
CTLA-4 inhibitors
Ipilimumab is another drug that boosts the immune response, but it blocks CTLA-4. This is a different checkpoint protein on T cells that normally helps keep them in check.
Ipilimumab is not used by itself. It is used with nivolumab (see above).
It is given as an infusion into a vein (IV), usually once every 3 weeks for 4 total treatments.
Possible side effects of CTLA-4 inhibitors
Side effects tend to be more common with this drug than with PD-1 and PD-L1 inhibitors.
The most common side effects from ipilimumab include:
- Fatigue (feeling tired)
- Diarrhea
- Skin rash
- Cough
- Itching
- Low blood counts
Like all checkpoint inhibitors, these drugs can also have more serious side effects, although it’s not common.
Possible serious side effects of all checkpoint inhibitors
Serious side effects are not common with these drugs, but they are possible.
- Infusion reactions: Some people might have an infusion reaction while getting one of these drugs. This is like an allergic reaction. It can include fever, chills, flushing of the face, rash, itchy skin, dizziness, wheezing, and trouble breathing. Tell your care team right away if you have any of these symptoms while getting one of these drugs.
- Autoimmune reactions: These drugs can also cause immune cells to attack healthy cells throughout your body. This can lead to problems with your lungs, gut, kidneys, hormone-making glands like the thyroid, or other organs.
Tell your healthcare team right away if you have any new side effects during or after treatment. This is very important. If serious side effects do happen, your treatment might need to be stopped, and you might need other treatments to stop these side effects.
Cytokines for kidney cancer
Cytokines are small proteins in the body that boost the immune system. Human-made versions of cytokines might sometimes be used to treat kidney cancer in very specific cases.
These are not often used anymore. However, they might be used to treat kidney cancer along with other immunotherapies in a small percentage of people.
In the past, IL-2 was often used as a first-line treatment for advanced kidney cancer. It may still be helpful for some people, but the newer immune checkpoint inhibitors and targeted drugs are more likely to be used today.
IL-2 is given by infusion through a vein (IV).
Possible side effects of IL-2
Side effects of IL-2 can include flu-like symptoms, such as fever, chills, aches, severe tiredness, drowsiness, and low blood cell counts. In high doses, IL-2 can cause fluid to build up in the body so that a person swells up and can feel very sick.
Because these side effects can be severe, high-dose IL-2 is only given in the hospital at certain centers that are experienced with this type of treatment.
In the past, interferon alfa was also used to boost the immune response to cancer cells. However, checkpoint inhibitors are more often used today.
More information about immunotherapy
To learn more about how drugs that work on the immune system are used to treat cancer, see Cancer Immunotherapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Atkins MB. Overview of the treatment of renal cell carcinoma. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/overview-of-the-treatment-of-renal-cell-carcinoma on August 12, 2026.
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George D, Jonasch E. Systemic therapy for advanced and metastatic clear cell renal cell carcinoma. UpToDate. 2026. https://www.uptodate.com/contents/systemic-therapy-for-advanced-and-metastatic-clear-cell-renal-cell-carcinoma on August 12, 2026.
National Cancer Institute. Renal Cell Cancer Treatment (PDQ). Accessed at https://www.cancer.gov/types/kidney/hp/kidney-treatment-pdq on August 12, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer Version 1.2027 – July 1, 2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf on August 12, 2026.
Rathmell WK, Rumble RB, Van Veldhuizen PJ, et al. Management of Metastatic Clear Cell Renal Cell Carcinoma: ASCO Guideline. J Clin Oncol. 2022;40(25):2957-2995.
Last Revised: November 2, 2026
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