The goal of biologic therapy, also known as immunotherapy, is to boost your body's immune system to fight and destroy cancer cells more effectively. Until recently, this was the most common first-line therapy for advanced renal cell carcinoma (RCC), and it may still be helpful for some of these patients.
The main immunotherapy drugs used in RCC are interleukin-2 (IL-2) and interferon-alpha. Both of these are cytokines—proteins that activate the immune system.
IL-2 is a growth factor for two types of white blood cells that may have potent anti-tumor effects: T cells and natural killer (NK) cells. A minority of patients with clear cell RCC (five to seven percent) can achieve long-lasting complete remission after IL-2 therapy. However, administration of high dose IL-2 is associated with many severe side effects and requires careful patient screening and selection. Patients receive their IL-2 treatment in the hospital. It is essential patients interested in IL-2 seek out a cancer center familiar with this style of therapy.
Side Effects of IL-2 Therapy
Side effects for IL-2 therapy may include nausea, vomiting, low blood pressure (hypotension), rapid heartbeat (rarely associated with heart attacks), swelling (edema), diarrhea or abdominal pain, loss of appetite, rashes, itching, mental changes, fever, and chills. Most of these side effects are completely reversible on discontinuation of drug administration, but they can be severe and, rarely, can be fatal. For this reason, cytokine therapy is not used in people who are in poor overall health. In addition, only doctors experienced in the use of these cytokines should give this treatment.
Interferon-alfa (Intron A)
Interferons prevent the growth of cancer cells and make them more susceptible to attack by other parts of the immune system. Interferon-alfa (IFN) is typically combined with bevacizumab (Avastin) for treatment of clear cell RCC. IFN is given as a subcutaneous injection three times a week.
Interferon Side Effects
The most common side effects of interferon therapy are flu-like symptoms and include fever, chills, muscle aches, headache, loss of appetite, and fatigue. These symptoms may become less severe with continued therapy. Medications may be prescribed to lessen the side effects. Side effects that may occur with prolonged use of interferons include weight loss, low white blood cell counts, loss of interest in sex, mental confusion, and depression. If severe, these side effects may require discontinuation of therapy.
Immunotherapy Side Effects
The side effects associated with immunotherapy vary greatly from person to person and depend on the type and dose of the drug(s) given, how they are given, and the length of time they are taken. Some people experience few, if any, side effects. Your doctor may give you medicines to lessen the severity of side effects or prevent them before they happen. See symptom management for more information.
The time it takes to get over some side effects and regain energy depends on many factors, including your overall health and your treatment.