Dr. Shiva Kumar Uppala, the senior Oncologist at Oncolndia, Bengaluru talks about immunotherapy for renal cancer and how it works.
Renal cancer or kidney cancer is a type of cancer that originates in the kidney. It is one of the top ten cancers that is seen in the Indian population. Generally, it affects older people in the age bracket of 40-60 years. Though it is known to occur in young people, it is usually a rare incidence. Renal cell carcinomas (RCCs) are the major type of renal cancer in our population.
Immunotherapy is the latest technique in the arsenal of oncologists in the fight against renal cancer. It works by helping the body’s innate immune system to fight off cancer. “There is an increasing and proven role of immunotherapy in renal cancer. It is one of the cancers where there is a good amount of immune component in treating which makes curing possible even in advanced stages of cancer,” says Dr. Shiva Kumar. It is more specific, with fewer side effects, and is extremely effective in most cases. However, it is costlier than chemotherapy and other forms of cancer treatment.
To understand why immunotherapy is highly successful in treating renal cancer, we must understand the biology of both our body and that of renal cancer. When renal cells mutate to form cancer cells, the body, in an attempt to eliminate these abnormal cells, brings the immune cells to the kidney. “This is evident by the presence of a large number of immune cells along with the cancerous cells in the biopsy samples taken from renal cancer patients,” says Dr. Shiva Kumar.
For the immune cells to successfully kill the cancer cells, the PD-1 receptor on the surface needs to be activated. However, the cancer cells prevent this activation by binding to the PD-1 receptors using PD-L1 proteins on their own surface. Therefore, the body is unable to fight off the cancer cells despite having an enormous army of immune cells at the site of the tumor. Immunotherapy is aimed at freeing PD1 receptors that are bound to PD-L1 proteins of the cancer cells, thereby activating the immune cells. This leads to the destruction of cancer cells by the immune system as they are different from the body’s normal cells.
Since immunotherapy is a costlier treatment, only patients who are positive for PD-L1 protein are suggested to undergo this therapy. When Dr. Shiva Kumar comes across a case where immunotherapy would cure his patient but they are unable to afford it, he personally gets involved. He rallies his friends, gets help from NGOs, and bears a portion of the treatment cost himself so that his patient is not denied a chance at being cancer free.
“Immunotherapy is an effective treatment for renal cancer in cases where it is suitable. It effectively removes the restraints placed on the immune system by the cancer cells, thereby fighting renal cancer from within,” says Dr. Shiva Kumar.
