Kidney cancer, also known as renal cell carcinoma (RCC), accounts for nearly 3% of all cancers, and in India, the annual incidence of kidney cancer stands at 16,861 cases, with a five-year prevalence rate of 2.84 per 100,000 population.
Historically known as a chemotherapy-resistant tumour, an additional hurdle in treating RCC remains its heterogeneity. Kidney tumours can be highly variable, even within the same patient. This means a "one-size-fitsall" approach often falls short.
Consequently, patients may experience resistance to treatments or suffer from side effects with limited benefit. RCC precision medicine is revolutionising this field by providing tailored treatments that improve patient outcomes and reduce side effects.
Minimal side-effects
Precision medicine presents a transformative approach in combating RCC, utilising the intricate insights derived from genetic and molecular profiling. This innovative method enables clinicians to decipher the unique genetic blueprint of each patient's tumour, akin to unlocking personalised genetic codes. Armed with this profound understanding, targeted therapies emerge as precisionguided tools, meticulously tailored to target the specific abnormalities within the tumour.
In contrast to conventional treatments, which often indiscriminately affect healthy cells, these therapies zero in on the precise pathways driving cancer growth. This dual benefit not only enhances treatment efficacy in shrinking tumours and controlling the disease but also minimises side effects by sparing healthy tissues. This precision-driven strategy holds the promise of not only improving treatment outcomes but also significantly enhancing the quality of life for patients undergoing therapy.
Targeted therapies
The foundation of precision medicine lies in genetic and molecular profiling. Advances in next-generation sequencing have made it possible to identify specific genetic mutations and molecular characteristics of kidney tumours. This information is crucial for developing targeted therapies that are more effective than traditional treatments.
Systemic therapy, administered intravenously or orally, plays a pivotal role in treating kidney cancers. Within this realm, two main types of systemic therapy stand out: targeted therapy and immunotherapy. Targeted therapy focuses on disrupting the mechanisms driving cancer cell growth.
These therapies can either target blood vessels that nourish tumours or inhibit proteins crucial for tumour proliferation and metastasis. Unlike traditional treatments, targeted therapies typically involve oral medications taken at home, offering patients greater convenience and flexibility. Immunotherapy, on the other hand, represents a paradigm shift in cancer treatment by harnessing the body's immune system to combat tumours.
Checkpoint inhibitors, a standard immunotherapy option for metastatic kidney cancer, function by reviving dormant immune cells and stimulating an immune response against cancer cells. Administered intravenously, these treatments necessitate regular clinic visits but are typically conducted in an outpatient setting, sparing patients the need for hospitalisation.
More recently, combinations of these treatments have shown great promise with superior treatment responses and improved survival. By focusing on specific cancer pathways, these personalised therapies minimise unnecessary side effects that can significantly impact a patient's quality of life. This allows patients to maintain a greater sense of normalcy during treatment, ultimately contributing to a more positive overall outcome
The road ahead
While precision medicine has made significant strides, ongoing research continues to expand its reach, promising an optimistic future for RCC treatment. Researchers are actively exploring new and more sophisticated biomarkers, paving the way for increasingly personalised treatment plans.
(The author is a genitourinary oncologist and cellular therapist at Memorial Sloan Kettering Cancer Center)