Treatment for kidney cancer has changed a lot in recent years. Now, doctors often use new types of medicines called immunotherapies, which help your own immune system fight the cancer. After kidney surgery, some patients get a drug called pembrolizumab to lower the risk of the cancer coming back. If the cancer has spread, it’s common to use a mix of immunotherapy and other medicines that block the cancer’s blood supply. These treatments are now the usual way to care for people with advanced kidney cancer.

However, not everyone has the same results from these treatments. This is because every person’s cancer is different, and sometimes the cancer becomes resistant to the medicines. Also, the tests we currently have to predict who will benefit from which treatment are not perfect.

Doctors and researchers are working to tailor treatments more closely to each patient’s type of cancer. They want to improve tests that can predict which treatments will work best, and to make sure these tests are reliable and used in the same way everywhere. They’re also looking at new ways to check if treatments are working as early as possible, so they can adjust if needed. Some rare forms of kidney cancer and cancers with particular genetic changes need more focused studies to find the best treatments for them.

Thanks to new treatments, many people are living longer and with better quality of life than before. Medicines that help the immune system and drugs that stop tumours from growing new blood vessels are now the main treatment for advanced cases. Pembrolizumab is also given after surgery in some people to try to stop the cancer from coming back. However, some people do not respond to these treatments or their cancer comes back anyway.

Researchers are now testing new medicines, including drugs like belzutifan (which blocks something called HIF-2α), and other drugs that target different cancer resistance pathways. There are also new treatments that combine antibodies with cancer-killing drugs or use immune cells to attack the cancer.

At the same time, scientists are working hard to find better ways to predict how each person’s cancer will behave. They are studying changes in certain genes (like PBRM1, SETD2, and BAP1) to see if these could help choose the best treatment. They are also looking at patterns in the cancer’s genetic material (DNA and RNA) to group tumours by their biology. New blood and urine tests that can spot cancer proteins or bits of tumour DNA might soon help doctors monitor patients more easily and catch any return of the disease sooner.

All these advances are moving kidney cancer care towards a more personalised approach, where treatment and follow-up are tailored to each person’s unique tumour.

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