The kidneys are responsible for filtering blood and removing metabolic waste from the body. However, due to their deep location in the abdominal cavity, even if tumours develop, they rarely press on surrounding organs or nerves in the early stages, often resulting in a lack of obvious symptoms. As a result, many patients are diagnosed only when the disease has progressed to distant metastases. For patients with advanced or metastatic kidney cancer, traditional treatments have certain limitations and unsatisfactory efficacy. In recent years, the medical community has introduced “targeted drugs combined with immunotherapy,” which uses targeted drugs to block cancer cell signalling and cut off the tumour’s nutrient supply, while activating the body’s T cells to more effectively eliminate cancer cells, achieving a dual therapeutic effect.
Kidney Cancer Known as "Silent Killer" with High Risk of Late-Stage Diagnosis
Kidney cancer is known as a "silent killer." Symptoms typically appear only when the disease reaches a certain stage, including the three classic signs: blood in the urine, non-traumatic unilateral lower back pain, and a palpable hard mass on the side of the waist or lower back. Clinical Oncologist Dr. Teo Man Lung, Peter, points out that due to the lack of early warning signs, over ten percent of patients in Hong Kong are diagnosed with late-stage kidney cancer. Once it reaches the advanced stage, the five-year survival rate drops significantly to less than twenty percent.
Limitations of Traditional Treatments: Single Approaches Fall Short
In the past, treatment for advanced or metastatic kidney cancer mainly relied on single-agent targeted therapy or dual immunotherapy. Dr. Teo notes that single-agent targeted therapy, introduced about twenty years ago, primarily targets vascular endothelial growth factor receptor (VEGFR) to inhibit tumour angiogenesis and delay disease progression. However, the overall response rate is relatively limited, and some patients do not achieve ideal outcomes. Subsequent dual immunotherapy has improved efficacy, but about twenty percent of patients still show no response; moreover, not all patients are suitable for the dual immunotherapy regimen, limiting treatment options.
New Treatment Direction: Synergistic Effect of Targeted Drugs and Immunotherapy
In recent years, "targeted drugs combined with immunotherapy" has emerged as an important direction for treating advanced kidney cancer. This approach combines the advantages of both, producing a synergistic effect. Dr. Teo explains that cancer cells can release signals to promote abnormal blood vessel growth for nutrient acquisition and establish immune evasion mechanisms to avoid clearance by the immune system. Targeted drugs inhibit tumour angiogenesis and improve the tumour microenvironment; on this basis, immunotherapy further activates T cells, enabling the immune system to more effectively recognise and attack cancer cells.
Clinical studies show that compared to traditional single-agent targeted therapy, this combination offers superior efficacy. Patients' progression-free survival (PFS) can be extended by more than double, with a median approaching two years. It also reduces mortality risk and increases tumour shrinkage rates. For patients with concurrent immune system diseases (such as lupus), the combination therapy is safer than dual immunotherapy, providing more personalised treatment options.
Patient Case Sharing: Stable Condition and Improved Quality of Life Post-Treatment
A lady in her mid-50s with Parkinson's disease, which made mobility difficult, was diagnosed in early 2021 with right kidney clear cell renal cell carcinoma. The cancer had already spread to both lungs and retroperitoneal lymph nodes, indicating a heavy tumour burden in an advanced case. After assessment, she received the "targeted drugs combined with immunotherapy" regimen. During approximately two years of treatment, CT scans showed significant tumour shrinkage, followed by stable condition. After completing the planned two-year immunotherapy course, she now only needs daily oral targeted medication for maintenance at home, without regular hospital visits for intravenous injections. Her latest CT scan in March 2026 showed continued stable tumour status, allowing her to maintain daily life and face it with a more relaxed mindset.
Finally, Dr. Teo reminds that every treatment has its benefits and side effects. Patients with any concerns should consult their attending doctor to select the most appropriate treatment.
More information:
Targetd Therapy: A Comprehensive Guide to Targeted Therapy Side Effects | Everything You Need to Know About Targeted Therapy and Its Common Side Effects | OncoCare
Immunotherapy: Immunotherapy Cancer Treatment Plans | OncoCare
Kidney Cancer Frequently Asked Questions
Q1: What are the common symptoms of advanced kidney cancer?
A: Patients may experience blood in the urine, non-traumatic unilateral lower back pain, and a palpable hard mass on the waist or lower back. However, there are often no obvious early warning signs.
Q2: What are the limitations of traditional treatments?
A: Single-agent targeted therapy has limited response rates, while dual immunotherapy has about twenty percent non-responders, and not all patients are suitable.
Q3: What are the advantages of targeted drugs combined with immunotherapy?
A: It can extend progression-free survival by more than double, increase tumour shrinkage rates, and offer a safer option for some patients with immune diseases. Every treatment has its benefits and side effects. Patients with any concerns should consult their attending doctor to select the most appropriate treatment.
Q4: How does treatment affect patients' lives?
A: As in the case above, after completing the course, patients can switch to oral maintenance therapy, reducing hospital visits and achieving more stable daily life.
Q5: How should patients choose a treatment plan?
A: Every treatment has its benefits and side effects. Patients with any concerns should consult their attending doctor to select the most appropriate treatment.
Related Media Coverage (Traditional Chinese Version Only):
WeChat ID: OncoCareMedC
