Over the past few years, there’s been tremendous progress in how doctors understand and treat renal cell (kidney) cancer. From new insights into the genetics behind the disease to more precise, personalized treatment options, below are some of the advancements you should know about.

Understanding the genetics of renal cell (kidney) cancer

Renal cell (kidney) cancer is complex because it isn’t just one disease, but rather a collection of different cancer types, each with its own genetic makeup. This discovery has transformed how doctors diagnose and treat renal cell (kidney) cancer.

Changes in certain genes play a key role in how renal cell (kidney) cancer develops. Understanding these changes has led to the development of new targeted treatments designed to block these genetic pathways.

About 5% of kidney cancers are inherited, meaning they’re passed down through families. Genetic testing can now identify if someone carries certain changes that increase their risk. For people with a family history of kidney cancer, genetic counseling and testing can help guide monitoring and prevention strategies.

Early detection research

Currently, there’s no standard screening test for kidney cancer in people at average risk, but there have been advancements in early detection using liquid biopsies. Liquid biopsies use blood samples to look for genetic markers of cancer and researchers are hopeful they can be used to detect kidney cancers early or monitor for recurrence after treatment.

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Evolving local treatment options

For many people, the first step in treating kidney cancer is to remove or destroy the tumor. Advances in surgical and localized therapies are making these procedures less invasive and more precise.

• Robotic-assisted laparoscopic surgery allows surgeons to remove kidney tumors through small incisions using robotic arms for greater accuracy.
• Ablative treatments such as microwave ablation and irreversible electroporation are being studied as minimally invasive ways to destroy tumors without traditional surgery.
• Stereotactic body radiation therapy (SBRT) delivers high doses of radiation to specific tumor sites with pinpoint accuracy.
  
  

Targeted therapy and immunotherapy

For advanced kidney cancers that can’t be completely removed with surgery, the focus has shifted toward targeted therapies and immunotherapy. Targeted therapies focus on the specific genetic change or alteration that’s driving the growth and spread of cancerous cells. Immunotherapies boost the body’s immune system to recognize and destroy cancer cells. These treatments can be used alone or in combination and ongoing research is helping doctors learn which combinations work best.

A promising new area of study involves CAR T-cell therapy, where a patient’s own immune cells are modified in the lab to find and attack kidney cancer cells that have a protein called CD70.

Advances in clear cell renal cell carcinoma treatment

The most common form of kidney cancer is clear cell renal cell carcinoma. Many of these cancers are linked to changes in the VHL gene. Drugs that target this pathway have become an important part of treatment.

For example, one newer drug belzutifan works by blocking a protein called HIF-2α, which plays a role in tumor growth. It’s approved for people with Von Hippel-Lindau disease, a hereditary condition that can cause kidney tumors. 

It’s also been approved for people with advanced RCC who have already received prior treatments. Researchers are now testing belzutifan in combination with other targeted therapies and immunotherapies to see if it can improve outcomes even further.

Expanding options for non-clear cell renal cell carcinoma

While clear cell renal is the most common type, there are other subtypes known as non-clear cell renal cell carcinomas. These can behave differently and may respond better to different treatments. Clinical trials are underway to determine which targeted drugs or immunotherapy combinations work best for these less common forms.

New strategies: Before and after surgery

Current research is also exploring how timing influences treatment efficacy. Doctors are examining how targeted and immunotherapies can be utilized before and after surgery to optimize survival and lower recurrence.

For some patients, giving treatment before surgery may help shrink tumors, making surgery easier or less invasive. It may even make previously inoperable tumors removable. For others, treatment after surgery can lower the risk of the cancer coming back in people with high-risk clear cell RCC. Researchers are focusing on which patients are most likely to benefit from these approaches.

Personalizing treatment for each patient

No two kidney cancers are exactly alike. Scientists are working to develop tests that predict how a person’s cancer will respond to certain treatments, helping doctors choose the most effective options while minimizing side effects.

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