NCCN Guidelines for Patients
Kidney Cancer, Version 1.2017
Overview of cancer treatments
The immune system is the body’s natural defense
against infection and disease. The immune system
includes many chemicals and proteins. These
chemicals and proteins are made naturally in your
Immunotherapy is treatment that increases the
activity of your immune system. By doing so, it
improves your body’s ability to find and destroy
cancer cells. Immunotherapy is used to treat kidney
cancer that has spread to other parts of the body.
Interferon alfa and IL-2 (interleukin-2)
Interferon alfa and IL-2 are proteins called cytokines
that stimulate immune cells. Cytokines are made
naturally in the body as part of the immune system.
But, these proteins can also be made in a lab to use
as treatment for cancer. Thus, interferon alfa and IL-2
are also called cytokine therapy.
Very high doses of IL-2 are used to treat kidney
cancer. This can cause severe and sometimes life-
threatening side effects. Some of the most common
side effects of IL-2 are: low blood pressure, abnormal
kidney and liver function tests, confusion, shortness
of breath, chills, nausea, vomiting, diarrhea, skin
rash, feeling tired or weak, and low urine output.
Rare, but serious side effects include breathing
problems, low blood pressure, kidney damage, fast
heartbeat, coma, bleeding, and infections.
Due to the serious risks, IL-2 is only used for certain
patients who are healthy enough to handle the side
effects. To consider this option, you must have good
overall health. Your kidneys and other organs must
also be working well. High-dose IL-2 should only be
given at a center that has expertise and experience
with this treatment. IL-2 is given as an infusion that
takes about 15 minutes. You will likely need to stay in
the hospital for several days during treatment.
Interferon alfa is not used alone to treat kidney
cancer. It is always given along with bevacizumab, a
targeted therapy drug. Interferon alfa is a liquid that
is injected under the skin with a needle. It is often
given three times a week.
Interferon alfa also has side effects, but not as
severe as IL-2. Side effects of interferon alfa often
include flu-like symptoms such as fever, chills, feeling
tired or weak, headache, and body aches. Other
common side effects are diarrhea, nausea, vomiting,
not feeling hungry, and depression.
Nivolumab is type of drug called a monoclonal
antibody or PD-1 (
blocking antibody. It attaches to and blocks the action
of the PD-1 protein on T-cells. T-cells are a main
type of white blood cell in the immune system. By
blocking PD-1, the immune system can then go after
cancer cells. The goal is to stop or slow the growth of
Nivolumab is an infusion given over 60 minutes,
usually every 2 weeks. You will be monitored in
the treatment area during and after the infusion for
any reactions. Your doctor can slow the rate of the
infusion or stop it any time if there is a concern. It is
important to let your doctor know if you experience
any side effects between treatment days. Side effects
of this drug may include feeling extremely tired,
nausea, diarrhea, constipation, not feeling hungry,
mouth sores, skin rash, cough, muscle pain, and joint