Targeted Therapy for Kidney Cancer
Targeted therapy is the use of medicines that target specific parts of cancer cells. It works to destroy cancer cells or slow their growth. Targeted therapy is used as part of treatment for some kidney cancers. Certain targeted drugs are sometimes used in combination with immunotherapy.
When is targeted therapy used for kidney cancer?
Targeted therapy might be used to treat:
- Kidney cancers that are at higher risk for coming back after surgery
- Advanced kidney cancers that cannot be controlled with surgery alone
- Kidney cancers that have relapsed (come back)
How does targeted therapy treat kidney cancer?
Tumors need blood and oxygen to grow. Some targeted drugs block the signals the body uses to grow new blood vessels and build cells. By blocking new blood vessels and other growth signals, the drugs can slow or stop cancer growth.
This type of targeted drug is called an angiogenesis inhibitor.
Several different angiogenesis inhibitors can be used to treat kidney cancer. These drugs are grouped based on the way they block the growth signals tumors need to survive.
Kinase inhibitors
Kinase inhibitors block proteins that are important for blood vessel growth and cancer cell growth and survival. Some kinase inhibitors block very specific proteins. Others act on several proteins and ways that cancer cells can grow.
Cabozantinib can be used to treat advanced kidney cancer, either by itself or along with the immunotherapy drug nivolumab (Opdivo).
This drug is taken as a pill, typically once a day.
Side effects
Common side effects of cabozantinib include:
- Diarrhea or constipation
- Fatigue (feeling tired)
- Nausea and vomiting
- Poor appetite and weight loss
- Belly pain
- Muscle pain
- High blood pressure
- Changes in skin or hair color
- Hand-foot syndrome
- Low blood cell counts
Less common but more serious side effects can include heart or liver failure, serious bleeding, blood clots, problems with wound healing, very high blood pressure, severe diarrhea, and holes forming in the intestines.
Lenvatinib can be used along with the immunotherapy drug pembrolizumab in people with advanced kidney cancer. It can also be used with the targeted drug everolimus for people with advanced kidney cancer that hasn’t responded to other treatments.
This drug is a capsule, typically taken once a day.
Side effects
Common side effects of lenvatinib include:
- Diarrhea or constipation
- Fatigue (feeling tired)
- Joint or muscle pain
- Loss of appetite
- Nausea and vomiting
- Belly pain
- Mouth sores
- Weight loss
- High blood pressure
- Hand-foot syndrome
- Low thyroid hormone levels
- Swelling in the arms or legs
Less common but more serious side effects can include heart or liver failure, serious bleeding, blood clots, problems with wound healing, very high blood pressure, severe diarrhea, and holes forming in the intestines.
Tivozanib can be used in people with advanced kidney cancer, or kidney cancer that has come back or has not responded well to other treatments.
This drug is a pill. It is typically taken daily for 3 weeks followed by 1 week off. The cycle is then repeated for as long as the drug is still helpful.
Side effects
Common side effects of tivozanib include:
- High blood pressure
- Fatigue (feeling tired)
- Diarrhea
- Nausea or vomiting
- Poor appetite
- Mouth sores
- Hand-foot syndrome
- Cough
- Voice changes
- Low blood counts
Less common but more serious side effects can include heart problems, life-threatening high blood pressure, blood clots, bleeding, poor wound healing, changes in thyroid hormone levels, and holes forming in the intestines.
Sunitinib can be used in people with advanced kidney cancer. It might also be an option for some people after surgery, to help lower the risk that the cancer will come back.
This drug is a pill taken by mouth daily, typically for 4 weeks on and 2 weeks off. Some doctors might recommend taking it 2 weeks on and 1 week off to reduce side effects.
Side effects
The most common side effects of sunitinib are:
- Nausea or vomiting
- Diarrhea
- Belly pain
- Loss of appetite
- Changes in skin or hair color
- Mouth sores
- Low white and red blood cell counts
Other possible effects include high blood pressure, heart problems, bleeding, hand-foot syndrome, low thyroid hormone levels, and feeling tired.
It can cause abnormal liver function test results, but it rarely leads to severe liver damage that could be life-threatening. Problems with bleeding, clotting, and wound healing can also happen.
In rare cases, sunitinib can cause a problem with the heart rhythm or even heart failure. If you are taking this drug, your healthcare team will monitor your heart with EKGs. They will also check your blood tests for liver or other problems.
Pazopanib might be used in people with advanced kidney cancer.
It is a pill taken by mouth once a day.
Side effects
Common side effects of pazopanib include:
- High blood pressure
- Nausea or vomiting
- Diarrhea
- Belly pain
- Decreased appetite
- Headaches
- Muscle pain
- Low blood cell counts
- Hair color change or loss
It can cause abnormal liver function test results, but it rarely leads to severe liver damage that could be life-threatening. Problems with bleeding, clotting, and wound healing can also happen.
In rare cases, pazopanib can cause a problem with the heart rhythm or even heart failure. If you are taking this drug, your healthcare team will monitor your heart with EKGs. They will also check your blood tests for liver or other problems.
Sorafenib can be used for advanced kidney cancer, usually after trying other treatments.
This drug is a pill taken by mouth twice a day.
Side effects
Common side effects of sorafenib include:
- High blood pressure
- Hair loss
- Loss of appetite
- Diarrhea
- Nausea or vomiting
- Skin changes
- Hand-foot syndrome
- Low blood counts
- Fatigue (feeling tired)
Less common but more serious side effects can include heart problems, life-threatening high blood pressure, blood clots, bleeding, and holes forming in the intestines.
VEGF inhibitors
Some targeted drugs work by blocking the vascular endothelial growth factor (VEGF) proteins. This blocks tumor and blood vessel growth.
Axitinib can be used alone or with certain immunotherapy drugs, like pembrolizumab or avelumab, as a treatment for people with advanced kidney cancer.
This drug is a pill, typically taken twice a day.
Side effects
Common side effects of axitinib include:
- High blood pressure
- Fatigue (feeling tired)
- Nausea and vomiting
- Diarrhea or constipation
- Poor appetite
- Weight loss
- Voice changes
- Hand-foot syndrome
- Low thyroid hormone levels
- Low blood counts
Less common but more serious side effects can include heart failure, serious bleeding, blood clots, problems with wound healing, and very high blood pressure.
EGFR inhibitors
This type of medicine blocks proteins called epidermal growth factors (EGFR). These proteins normally cause cells to grow and survive. When the proteins are blocked, cancer cells and blood vessels cannot grow.
Erlotinib can be used for advanced papillary renal cell carcinoma. It is most used for FH-deficient renal cancer, a kidney cancer caused by a specific gene change. It is used with the targeted drug bevacizumab.
This drug is a pill taken once a day.
Side effects
Common side effects of erlotinib include:
- Skin rashes
- Low appetite
- Diarrhea
- Nausea and vomiting
- Increased risk of infections
- Fatigue (feeling tired)
- Cough
- Shortness of breath
Less common but more serious side effects can include serious eye, skin, and lung problems and holes forming in the intestines.
HIF-2α inhibitors
This type of medicine blocks a specific protein called hypoxia-inducible factor 2 alpha (HIF-2α). The protein is involved in both cancer cell growth and new blood vessel formation in tumors.
Belzutifan is taken as a pill, typically once a day.
It can be used in people with:
- Von Hippel-Lindau (VHL) disease who have kidney cancer and do not need surgery right away
- Advanced kidney cancer that has already been treated with a different targeted drug and an immune checkpoint inhibitor
- Advanced kidney cancer that has already been treated with an immune checkpoint inhibitor, along with lenvatinib
- Clear cell renal cell carcinoma when the cancer can be removed but there is a higher risk of it coming back
Side effects
Common side effects of belzutifan include:
- Low red blood cell counts (anemia)
- Feeling tired and/or dizzy
- Nausea
- Headache
- Changes in lab tests showing the drug might be affecting the kidneys
- Muscle or joint pain
Less common but more serious side effects can include:
- Very low red blood cell counts (severe anemia). If this happens, you might need a blood transfusion.
- Low oxygen levels in the body. If this happens, you might need oxygen therapy or need to be admitted to the hospital.
mTOR inhibitors
Certain drugs target mTOR proteins. These proteins normally help cells grow and divide.
Temsirolimus can be used to treat advanced kidney cancers. It is usually used after other drug treatments have been tried.
This drug is given by infusion into a vein (IV), typically once a week.
Side effects
The most common side effects of temsirolimus include:
- Skin rash
- Weakness
- Mouth sores
- Nausea or vomiting
- Loss of appetite
- Belly pain
- Constipation or diarrhea
- Fluid buildup in the face or legs
- Increases in blood sugar and cholesterol levels
- Low blood counts
Rarely, it can cause more serious side effects such as lung or kidney problems, problems with wound healing, and holes forming in the intestines.
Everolimus can be used to treat advanced kidney cancers. It can be used by itself or along with other targeted drugs such as lenvatinib or bevacizumab, usually after at least one other drug treatment has been tried.
This drug is taken as a pill, typically once a day.
Side effects
Common side effects of everolimus include:
- Mouth sores
- Increased risk of infection
- Nausea
- Loss of appetite
- Diarrhea
- Skin rash
- Feeling tired or weak
- Headaches
- High blood pressure
- Fluid buildup, usually in the legs
- Increased blood sugar and cholesterol levels
- Low blood counts
Rarely, it can cause more serious side effects such as lung or kidney problems, problems with wound healing, and blood clots.
Monoclonal antibodies
Monoclonal antibodies are lab-made antibodies (immune proteins) designed to target a specific protein.
Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF). This drug works by blocking new blood vessels from forming. It can be used to treat advanced kidney cancer, either alone or along with another drug. It is most often used after other drug treatments have been tried.
This drug is given by infusion into a vein (IV), typically once every 2 weeks.
Side effects
Side effects of bevacizumab can include:
- High blood pressure
- Low appetite
- Diarrhea
- Belly pain
- Nausea
- Feeling tired
- Headaches
- Low blood counts
- Muscle or joint pain
Less common but more serious side effects can include heart failure, serious bleeding, blood clots, problems with wound healing, very high blood pressure, and holes forming in the intestines.
More information about targeted therapy
To learn more about how targeted drugs are used to treat cancer, see Targeted Cancer Therapy.
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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Last Revised: November 2, 2026
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