Immunotherapy

Immunotherapy is a treatment option for kidney cancer that has spread to other parts of the body (metastatic kidney cancer). It is only used in certain situations. If you are in generally good health and have only a few tumours in your kidneys, your doctor may suggest this treatment.

How it works

Cancer cells usually hide from the immune system by using special proteins called "checkpoints." Immunotherapy drugs block these checkpoints, helping the immune system find and attack the cancer cells.

Cytokines

Cytokines are proteins that help the immune system work properly. They send signals between cells to fight infections, heal the body, and respond to diseases like cancer. 

Cytokines, like Interleukin-2 (IL-2) and Interferon-alpha (INF-α), are used to treat metastatic kidney cancer. However, they can cause serious side effects because they make the immune system work very hard.

• Interleukin-2 (IL-2)
  If your doctor recommends Interleukin-2, you will need to stay in the hospital during treatment because it can cause serious side effects. Because of this, it is only available in certain countries and specialised hospitals. It is given as an injection into a vein 3 times a day for a couple of weeks.
• Interferon-alpha (INF-α)
  If your kidney cancer has only spread to your lungs, your doctor may suggest Interferon-alpha. This treatment is usually given with another drug called bevacizumab, which helps stop the tumour from growing. The side effects are milder compared to IL-2. It is given as an injection under the skin, 3 times a week.

The side effects of immunotherapy

Immunotherapy can cause side effects that can range from mild to more serious. The most common ones are feeling tired and having flu-like symptoms, such as fever, chills, headaches, and muscle or joint pain. Most people notice these symptoms at the start of treatment, but they usually get better over time. These symptoms typically happen 2 to 4 hours after the injection and last for about 12 hours. Taking paracetamol can help ease the discomfort.

Immunotherapy can also lower your red or white blood cells, or platelets. Fewer white blood cells can increase the risk of infections, and fewer red blood cells can make you feel tired or short of breath. If these levels drop too much, you might need a blood transfusion. Fewer platelets can cause nosebleeds, bleeding gums when brushing your teeth, or small red spots or bruises on your arms and legs. You may also get dry or itchy skin, or a rash.

If you notice any of these side effects, it's important to contact your doctor. They will keep track of your blood counts regularly.

Other side effects may include nausea, vomiting, diarrhoea, loss of appetite, and changes in your taste or a metallic taste in your mouth. You may also have a sore throat or pain when swallowing. If these symptoms don’t go away, they can lead to dehydration, weight loss, or malnutrition, so be sure to tell your doctor or nurse.

During treatment, you might also feel anxious, depressed, or have trouble sleeping. These feelings can be a side effect of the treatment, but they may also be related to your diagnosis. If you need help, ask your doctor or nurse about support services, they can provide someone for you to talk to.

The information provided here is general and may vary based on where you live. You may want to ask your doctor for advice that's specific to your situation. 

Here are some questions you can ask your doctor:

• Is immunotherapy the right treatment for my kidney cancer?
• How does immunotherapy work to treat my cancer?
• What side effects might I experience with immunotherapy?
• How will I know if immunotherapy is working?
• How long will I need to take immunotherapy?
• What are the chances that immunotherapy will help me?
• Are there other treatment options I should consider?
• How can I manage the side effects of immunotherapy?
• Will immunotherapy affect my daily life?
• Are there any long-lasting effects I should know about?
• Will I need to stay in the hospital for immunotherapy?
• How often will I need treatment or check-ups?
• Can immunotherapy be used with other treatments, like surgery or targeted therapy (antiangiogenic therapy)?
• What should I do if I have any side effects?
• How will you check if the treatment is working?

This chapter contains general information about immunotherapy for kidney cancer. If you have any specific questions about your own medical situation you should consult your doctor or other professional healthcare provider. No website or leaflet can replace a personal conversation with your doctor.

Last updated: February 2025