New findings about the biology of kidney cancer, inspired by scientific breakthroughs recognized with a Nobel Prize, have contributed to improved treatments and better survival rates.
Recent discoveries regarding kidney cancer’s biology—highlighted by Nobel Prize-winning research—have spurred advancements in treatment options and enhanced survival rates, according to a review from William Kim, MD, and Tracy Rose, MD, MPH, at the UNC Lineberger Comprehensive Cancer Center.
Their insights, based on a comprehensive analysis of 89 studies conducted between January 2013 and January 2024, were published in JAMA on August 28.
“The 2019 Nobel Prize in Medicine or Physiology was awarded for revealing how mammalian cells perceive oxygen,” explained Kim, who holds the Rush S. Dickson Distinguished Professorship in Medicine at the UNC School of Medicine and co-leads the UNC Lineberger Cancer Genetics Research Program. “A crucial element of this oxygen sensing mechanism is the von Hippel-Lindau tumor suppressor gene, which is altered in around 90% of kidney cancer cases. This profound understanding of kidney cancer biology has facilitated significant therapeutic breakthroughs in recent years.”
Kim trained as a postdoctoral fellow under William G. Kaelin, Jr., MD, who shared the 2019 Nobel Prize for showcasing how the von Hippel-Lindau gene affects cellular reactions to varying oxygen levels.
The American Cancer Society estimates that over 81,500 individuals will be diagnosed with kidney cancer in the United States this year, leading to an expected 14,300 fatalities. While the rate of kidney cancer diagnoses has risen by about 1.5% each year as of late, there has been a decrease in mortality rates of approximately 2% annually from 2016 to 2020.
This decline in deaths is mainly attributed to better treatment options and earlier detection. “Today, most kidney cancer diagnoses are made incidentally, often before symptoms emerge,” stated Kim. He pointed out that increased use of abdominal imaging for various issues has resulted in the accidental identification of kidney cancer. “More cases are being caught in their earlier stages, when the cancer typically responds better to treatment.”
Major risk factors for kidney cancer include cigarette smoking and obesity, which account for nearly half of kidney cancer cases in the United States. Other factors such as high blood pressure, a history of kidney cancer in the family, exposure to certain workplace chemicals, and inherited conditions like von Hippel-Lindau disease also contribute to the risk.
Standard treatment methods encompass surgery to excise part or the entirety of the kidney, ablation techniques utilizing targeted heat or cold to eliminate the tumor, or active monitoring through imaging technologies. For cancers that have spread beyond the kidney, newer treatment alternatives consist of immune checkpoint inhibitors, tyrosine kinase inhibitors, or a hybrid of these approaches.
“Advanced metastatic kidney cancer can be effectively treated with targeted therapy, immunotherapy, or a combination of these modern treatments,” asserted Rose, who is an associate professor of medicine at the UNC School of Medicine. “A comprehensive understanding of the disease’s underlying science has enabled the strategic development of therapies, significantly benefitting many patients over the past twenty years.”
