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Research into the causes, detection, diagnosis, and treatment of kidney cancer (renal cell carcinoma) is being done at many medical centers, university hospitals, and other institutions across the nation.
The most common type of renal cell carcinoma (RCC) is called clear cell. About 20% are different subtypes and called non-clear cell RCCs. Initial studies seem to show that they do not respond as well to targeted therapy drugs and appear to have poorer outcomes. More research is being done to find out how each subtype of non-clear cell RCC behaves in the hope this information will help guide better treatments for this type of kidney cancer.
Because chemotherapy is not very effective against advanced kidney cancer, immune therapy drugs combinations, combinations of immune therapies with targeted therapies, and targeted therapies are now usually the first-line option to treat kidney cancers that cannot be removed by surgery or have spread outside the kidney. More research is being done to see which people with kidney cancer will benefit most from targeted therapy, immunotherapy or combinations.
Giving targeted drugs before surgery (called neoadjuvant therapy) is also being studied to see if it will shrink large, bulky tumors to allow for less extensive surgery, prevent cancer spread, and hopefully improve cure rates. This could also help people retain more of their normal kidney function.
Giving targeted drugs after surgery (called adjuvant therapy) is also being studied to reduce the chances of the cancer coming back in patients at high risk of recurrence. To date, sunitinib (Sutent) is the only targeted drug approved for this, but it does not appear to help people live longer.
Along with finding new medicines and looking at the best way to combine and sequence existing ones, a major area of research is finding better ways to choose the best treatment for each person. Researchers are looking for which factors might make a person's cancer more likely to respond to a certain medicine. This can increase the chances of being helped by a therapy and lower the chances a person will get a treatment that is unlikely to help them (and which could still have side effects).
A common side effect of targeted therapy is high blood pressure. One study has shown that people who developed high blood pressure while taking sunitinib responded better to the treatment than those whose blood pressure remained normal. More research is being done to try to find out what other factors seen during targeted therapy treatment might help predict whose cancer is responding or not responding so adjustments can be made if needed.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Correa AF, Lane BR, Rini BI, Uzzo RG. Ch 66 - Cancer of the kidney. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
Dey S, Peabody HN, Noyes SL, Lane BR. Neoadjuvant Targeted Molecular Therapy Before Renal Surgery. Urol Clin N Am. 2017; 44; 289–303.
Graham J, Heng DC, Brugarolas J and Vaishampayan U. Personalized Management of Advanced Kidney Cancer. Am Soc Clin Oncol Educ Book. 2018; 38: 330-341.doi: 10.1200/EDBK_201215.
McNamara MA, Zhang T, Harrison MR, George DJ. Ch 79 - Cancer of the kidney. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier: 2020.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer. V.2.2020. Accessed at: www.nccn.org on November 12, 2019.
Pal SK, Haas NB. Adjuvant Therapy for Renal Cell Carcinoma: Past, Present, and Future. The Oncologist. 2014;19:851–859.
Zhang T, Gong J, Maia MC, Pal SK. Systemic Therapy for Non-Clear Cell Renal Cell Carcinoma. Am Soc Clin Oncol Educ Book. 2017;37:337-342. doi: 10.14694/EDBK_175572.
Last Revised: February 1, 2020
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