Kidney Cancer: Biologic Therapy (Immunotherapy)

What is biologic therapy?

Biologic therapy is a type of treatment for cancer that uses your body’s own immune system to fight and kill cancer cells. It’s also known as immunotherapy. It uses medicines that boost, focus, or restore certain parts of the immune system. The medicines help your immune cells recognize and attack the cancer cells.

When might biologic therapy be used for kidney cancer?

Your healthcare provider may suggest this treatment if the cancer has spread beyond your kidney or come back after treatment. 

How is biologic therapy given for kidney cancer?

Biologic therapy may be given as pills, by injection, or through an IV.

There are 2 main lab-made proteins (cytokines) used in biologic therapy for kidney cancer. They act like natural proteins to turn on the immune system. These cytokines are:

• Interferon alpha

• Interleukin-2

Interferon alpha is most often given with another medicine called bevacizumab. If you take interferon, you may need it for a long time. It's common to take it for several years, as long as it is working and the side effects aren't too severe. You'll most likely get it as a daily injection. You can get this as an outpatient at a hospital, clinic, or healthcare provider’s office. This means you go home the same day. Or you may learn how to give it to yourself at home. 

Interleukin-2 only works in a small number of people. But it gives longer-lasting effects when it works. Low or medium doses of Interleukin-2 may give given as outpatient therapy. High doses may work better for some people. High-dose therapy is given in a hospital with experience using the treatment.

New types of biologic therapy medicines, like nivolumab, are also being used to treat kidney cancers that grow after getting other treatments.

What are the possible side effects of biologic therapy?

Like most types of cancer treatment, biologic therapy causes side effects. Some can be severe. They usually get better after the treatment ends. Side effects depend on the type and amount of medicines you’re taking. They vary from person to person.

Possible side effects include:

• Appetite loss

• Dizziness

• Drowsiness

• Headaches, muscle aches, joint aches, or bone pain

• Redness, swelling, or discomfort at the injection site

• Nausea and vomiting

• Skin rash or dryness

• Taste changes or metallic taste in mouth

• Less urination

• Weight gain

Serious side effects can include:

• Changes in mental function

• Low blood pressure

• Diarrhea

• Pain in the belly (abdomen)

• Chills with a high fever

• Extreme tiredness (fatigue)

• Fast heartbeat

Other severe side effects are possible, such as:

• Heart attack

• Bleeding in the intestines

• Buildup of fluid in the lungs

• Trouble breathing

• Kidney damage

In rare cases, some of these side effects can be fatal. Because of the risk of severe side effects, biologic therapy is used to treat kidney cancer only in people who are in good overall health and who can cope with the difficult treatment.

Talking with your healthcare provider

Make sure to talk with your healthcare provider about these medicines and their effects. Your provider will discuss the risks and benefits with you.

Also be sure to talk with your healthcare providers about what signs to look for and when to call them. For example, it's normal to have a slight fever after biologic therapy. But if you have a fever of 101.5°F (38.6°C) or higher or other symptoms that last for more than 2 days, call your healthcare provider. It could be a sign of infection. Make sure you know what number to call with questions or problems. Is there a different number for evenings and weekends?

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your medical team to make a plan to manage your side effects.