Immunotherapy treatment for kidney cancer in Germany
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Immunotherapy is the most rapidly developing area of oncology. It is used for most types of cancer. Moreover, some tumors are much more sensitive to immunotherapy than others, and kidney cancer also belongs to this group of tumors. Immunotherapy is very successful for this disease and can be used at almost all stages in order to lower the risk of relapse after surgery and control metastatic tumors. Doctors in Germany use both standard and experimental treatment methods, which are still being tested in clinical trials.
Content
- Types of immunotherapy for kidney cancer treatment
- When can immunotherapy be prescribed for kidney cancer treatment?
- How is immunotherapy different from other treatments?
- How is immunotherapy for kidney cancer treatment performed?
- Benefits of immunotherapy in kidney cancer treatment
Types of immunotherapy for kidney cancer treatment
Standard methods include two types of kidney cancer immunotherapy. Since the 1990s, cytokines have been used, which then gave way to ICIs as safer and more effective drugs.
Immune checkpoint inhibitors (ICIs). Doctors use drugs with different mechanisms of action. They belong to PD-1, PD-L1, or CTLA-4 inhibitors. All of these drugs "turn off" molecules that help cancer cells hide from attacks by the immune system by masking as normal cells. ICIs do not have a direct cytotoxic effect but only enhance the antitumor immune response. Therefore, drugs in this group are usually well tolerated and rarely cause severe complications.
Cytokines. These drugs used to be commonly applied in the past, but doctors rarely use them today due to the fact that more effective immunotherapy drugs, such as ICIs, have appeared. There are two types of cytokines used in oncology: interleukin-2 and interferon-alpha.
Interleukin-2 provides a dose-dependent effect, increasing patient survival and shrinking tumor size. But the problem is that as the dose increases, along with the effectiveness, the toxicity of the treatment also increases. High doses may cause severe side effects, so treatment with interleukin-2 is carried out in specialized hospitals, whose doctors are able to provide quick and qualified care to patients in cases of complications.
Interferon-alpha is safer, but it is also less effective. Therefore, it is never used as monotherapy. This drug is only an addition to other types of treatment. Interferon-alpha is most often combined with targeted therapy using bevacizumab.
Experimental treatments. These methods are not yet approved but are being tested in clinical trials. The greatest hopes are associated with the following types of immunotherapy for kidney cancer:
- CAR T-cell therapy using anti-CD70 cells involves collecting immune cells from a person, changing their genome, and returning them to the body to stimulate an anti-tumor immune response
- Personalized vaccines using neoantigens involve collecting immune cells from a person, treating them with tumor antigens, and injecting them again into the body
- New immune checkpoint inhibitors: anti-LAG3 and anti-TIGIT
When can immunotherapy be prescribed for kidney cancer treatment?
PD-1 inhibitors may be prescribed in the following cases:
- After surgery, in cases of high risk of relapse, course for 12 months
- After surgery to remove metastases
- As first-line therapy for inoperable kidney cancer
- In cases of cancer relapse after initial treatment
PD-L1 inhibitors are used in combination with targeted therapy for metastatic kidney cancer as a first-line treatment.
CTLA-4 inhibitors cannot be used as a stand-alone method. They are included in the treatment regimen in addition to PD-1 inhibitors. This regimen is usually used for low- or intermediate-risk patients with metastatic kidney cancer. The drug ipilimumab is administered four times, and then therapy is continued with only PD-1 inhibitors.
How is immunotherapy different from other treatments?
Most drug treatments are aimed at killing cancer cells. The drugs themselves, which are administered into the body, have a cytotoxic effect and have a stronger effect on those cells that quickly divide or have certain receptors on their surface.
The mechanism of action of immunotherapy is, however, fundamentally different from that of other drugs. The drugs used do not destroy cancer cells themselves but only force the human immune system to more actively attack the tumor.
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How is immunotherapy for kidney cancer treatment performed?
ICIs are most often used to treat kidney cancer. They are prescribed as monotherapy or combined using drugs from different pharmacological groups. These drugs are also often combined with targeted therapies.
Different ICIs are used in different ways. In addition, treatment regimens for different patients differ significantly depending on the stage of cancer and the goals of immunotherapy. Most drugs are administered intravenously. Intervals between infusions range from 2 to 6 weeks.
Benefits of immunotherapy in kidney cancer treatment
Kidney cancer is one of the tumors sensitive to immunotherapy. Therefore, this type of treatment ranks second in importance, second only to surgery, but superior in effectiveness to radiation therapy and chemotherapy.
The method is applicable to most patients. It is used both to prevent recurrence after kidney removal surgery and to control metastatic tumors. Immunotherapy is the main treatment option for patients with unresectable tumors.
Below are the benefits of immunotherapy:
- The most effective method among systemic treatments for kidney cancer
- This therapy affects not only the primary tumor but also all metastases
- It provides long-term cancer control
- In some patients, it ensures the complete disappearance of all tumors
- The therapy works for most histological types of kidney cancer
- It can be combined with other treatments
- It is a patient-friendly therapy because the drugs are administered once every few months
Many drugs have already been approved for kidney cancer immunotherapy, mainly ICIs. Using their combinations, doctors achieve better treatment success rates.
| Stages of kidney cancer | Immunotherapy | Chemotherapy | Targeted therapy | Radiation therapy |
| Localized | 90% | – | – | – |
| Locally advanced | 85% | – | 60% | – |
| Metastatic | 70% | 20% | 50% | 30% |
In most patients, immunotherapy treatment for kidney cancer is combined with targeted therapy. This combination makes it possible to control even stage 4 cancer for many years.
You can travel to Germany to undergo immunotherapy for kidney disease. Immunotherapy has been successfully used here for decades. Doctors have extensive experience in treating all stages of kidney cancer and use the very latest drugs. Moreover, it is in Germany that many immunotherapy methods are being developed and researched.
You can make an appointment for your treatment, select a clinic, and find out the average cost of treatment on the Booking Health website. When you make an appointment through our service, the cost of medical services abroad will be lower for you due to the absence of additional fees for foreign patients. The Booking Health specialists will help you find a medical center specializing in immunotherapy and organize your trip.
Choose treatment abroad and you will for sure get the best results!
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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Sources:
Read:
Cancer immunotherapy in Germany
Treatment of stage 4 kidney cancer in Germany
New Effective Treatments for Stage 4 Cancer (oncology)
Adaptive Cell Therapy: CAR T-Cell Therapy