Kidney cancer 2015: Many clinical trials – and a growing need
December 22, 2014 | by Tami Dennis
The need for clinical trials of new kidney cancer treatments has never been greater: Kidney cancer is one of the most common cancers in both men and women – and the rates are rising.
Fortunately for kidney cancer patients everywhere, there's City of Hope. “City of Hope has more active clinical trials for kidney cancer patients than any other center in the region,” said Sumanta Pal, M.D., co-director of the Kidney Cancer Program at City of Hope. Many of these trials focus on a novel method of stimulating the body’s own immune system to act against cancer.
This novel method entails use of drugs called ‘programmed death-1,’ or PD-1, inhibitors. Such drugs work with the natural checks and balances within the immune system, Pal said, explaining that PD-1 inhibitors stifle the body’s suppression of the anti-tumor immune response.
“In early phase studies, these drugs appear to be highly effective in kidney cancer, producing survival that goes well beyond traditional expectations,” Pal said. “At City of Hope, two drugs in this category, nivoluma and MDPL3280A, are being explored in patients with newly diagnosed kidney cancer with disease spread outside of the kidney.”
Other promising studies are taking shape as well, including research into rare types of kidney cancer such as papillary kidney cancer, which makes up only about 10 to 15 percent of kidney cancer cases.
Scientists at City of Hope have received a grant to fund research exploring novel drugs for papillary kidney cancer in mouse models of the disease. “We currently have a study underway in patients using a novel drug called AZD6049, a molecularly targeted drug that blocks a pathway that seems to be critical in papillary kidney cancer,” Pal said. “We also have a collaboration with the National Institutes of Health to perform a large trial including hundreds of patients using similar agents.”
Combating side effects
Physicians also want to make the day-to-day lives of kidney cancer patients better. “Although new drugs for the disease offer a lesser degree of toxicity than chemotherapy, certain side effects (such as diarrhea and fatigue) still persist,” Pal said.
He has conducted a study using a novel bacterial profiling tool to characterize the bacterial composition of stool in patients receiving treatments of kidney cancer. He has identified several bacteria that are potentially protective against diarrhea. “Ultimately, one can envision that a probiotic supplement or similar agent could be used to prevent treatment-related diarrhea,” Pal said.
Pal is also helping assess the effectiveness of the drugs BNC105P and pazopanib for patients with kidney cancer. BNC105P is a so-called vascular disrupting agent, meaning that it works by decreasing the tumor’s blood supply, and could hold significant promise. The benefits of Pazopanib, however, already used to treat kidney cancer, may be hampered by drug resistance due to immune changes in the body.
The clinical trials currently underway, however, may provide new, perhaps even better, options.
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.