Dr. Brad Hirsch of Texas Oncology–Medical City Dallas Building D discusses treatment options for kidney cancer, breakthroughs in research, and important messages to keep in mind.
What are the most effective forms of treatment available for kidney cancer?
Treatments vary depending on the extent of disease at diagnosis, but require consideration of multiple types of therapy including surgery, radiation, and systemic agents. Surgery remains the primary focus for disease that hasn’t spread far beyond the kidney. But even for more extensive local disease, the FDA recently approved the use of Sunitinib to decrease the chance of recurrence. For those with more extensive disease, there have been numerous new agents approved to treat the disease.
How have you seen the options for kidney cancer treatment evolve throughout your career, thanks to breakthroughs in research?
We have seen dramatic changes in the treatment of kidney cancer over the past decade, making it an exciting time to be able to take care of patients. When I first started practicing, there were few available agents and those that were could be quite toxic. The change started with an influx of targeted therapies that focus on specific pathways seen in kidney cancer, increasing the response rate while decreasing the toxicity of the drugs. More recently, we have seen the approval of immunotherapies that leverage a patient’s immune system to fight the disease. Earlier this month the results of trials were published in the New England Journal of Medicine showing promising results for combinations of agents. I believe that this is just the beginning as we better understand the mutations underlying kidney cancer and further tailor the therapy that we provide.
In your opinion, what is the most important message to keep in mind about kidney cancer awareness?
The treatment approach has changed dramatically over the past 10 to15 years with many options available to treat kidney cancer. This is incredibly exciting for patients as they can live far longer with better quality of life. At the same time, it has become increasingly complex to understand when to use a given agent and in what combination. I have been fortunate to be a part of startups leveraging data and technology to advance the scope of knowledge in oncology and to then apply it to the patients that I have the honor of taking care of every day. I see great opportunity to better understand a given patient’s needs and ability to treat them in a very personalized fashion. While it isn’t a perfect science today, we are making great strides. We need to find a cure. However, I hope that we can continue to work to make kidney cancer a chronic disease in the meantime.