Targeted and immunotherapy drugs for advanced kidney cancer

You might have targeted and immunotherapy drugs if the cancer has spread away from your kidney (advanced kidney cancer). Which drugs you have depends on the type of kidney cancer. It also depends on what treatment you have already had.

This page is about targeted and immunotherapy drugs for advanced kidney cancer. You may also have immunotherapy after surgery for kidney cancer if there is a high chance of it coming back.

What are targeted and immunotherapy cancer drugs?

Targeted cancer drugs target the differences in cancer cells. These differences help them grow and survive. Other drugs help the immune system attack cancer. These are called immunotherapies.

Some drugs work in more ways than one. They target the differences in cancer cells and work with the immune system. 

When you might have targeted and immunotherapy drugs for advanced kidney cancer

Targeted and immunotherapy drugs can help some people with advanced kidney cancer. Kidney cancer may be advanced when you are first diagnosed. Or it has come back after previous treatment.

These treatments are unlikely to cure the cancer, but they may help to control it for a time and help some people live longer.

Different treatments work for different people. Your doctor will look at a number of factors to decide which treatment is best for you. This includes: 

• the type of kidney cells the cancer has started in
• how abnormal the cells look (grade) and whether they are growing fast or slow
• how far the cancer has grown or spread (the stage)
• your symptoms
• your general health
• the treatments you have had already

Types of targeted cancer drugs or immunotherapy for advanced kidney cancer

For advanced kidney cancer you might have a targeted cancer drug, an immunotherapy drug or both together. Sometimes you might have 2 targeted drugs or 2 immunotherapy drugs together. The first course of drug treatment you have is the first line treatment.

Targeted drugs

You might have one of these targeted drugs as your first line treatment:

• sunitinib (Sutent) 

• pazopanib (Votrient) 

• tivozanib (Fotivda)

• cabozantinib (Cabometyz)

Immunotherapy

Your doctor may recommend you have nivolumab (Opdivo) with ipilimumab (Yervoy) as first line treatment. These are both immunotherapy drugs.

Targeted drugs with immunotherapy

Sometimes you may have treatment with a targeted drug and an immunotherapy drug. This could be:

• avelumab (Bavencio) with axitinib (Inlyta)

• lenvatinib (Kisplyx) with pembrolizumab (Keytruda)

• cabozantinib with nivolumab

Pembrolizumab with axitinib is also currently approved for use on the NHS in Scotland.

If your treatment stops working

If the cancer starts growing again, your doctor may recommend another treatment. This is called second line treatment. If necessary you may have a third line treatment afterwards.

You may have one of the following drugs as a second or third line treatment:

• cabozantinib
• axitinib
• everolimus (Afinitor)
• lenvatinib (Kisplyx) with everolimus

If you haven't had an immunotherapy drug already you may have nivolumab as a second or third line treatment.

Having targeted and immunotherapy drug treatment

You may have your treatment as:

• tablets or capsules
• through a tube into your bloodstream
• a combination of tablets or capsules and into your bloodstream

How you have the treatment depends on which drugs you have.

Side effects

Targeted therapy drugs and immunotherapy drugs can cause different side effects. Some of these can be serious. Your doctor or nurse will talk to you about this. Always tell them about any side effects you have and follow the advice they give you.

Go to our A to Z list of cancer drugs to read about the drugs on this page and their side effects.

Research into targeted cancer drugs and immunotherapy for kidney cancer

Researchers continue to look at different targeted and immunotherapy drugs and how they are given.

This includes:

• new drugs

• different combinations of existing drugs

• combining immunotherapy with chemotherapy

• whether immunotherapy drugs can be given less often

You may have treatment for advanced cancer as part of a clinical trial.