Exploring the Role of Radiation Oncology in Kidney Cancer Awareness Month

In light of Kidney Cancer Awareness Month in March, Brandon Mancini, MD, MBA, FACRO, spoke with Chad Tang, MD, about broad developments and themes in the care of different kidney cancer populations. Together, in this week’s episode of RadOnc on the Run, the experts highlighted technological advances, safety considerations, and other areas that may elevate the quality of care across the field.

Despite previous historical data showing that kidney cancer may not respond to radiotherapy, Tang noted that being able to achieve better targeting with modern high-dose radiation modalities may push back against the notion that radiation doesn’t have a role in kidney cancer management. Describing a “renaissance” across the last 5 to 10 years in the field, Tang said that radiation oncology can play a role at every level of kidney cancer care, including definitive, localized treatment as well as palliative care.

The conversation also touched upon optimizing dosing fractionation and schedules, with Tang outlining a preference for 3- or 5-fraction radiation delivery, depending on tumor size and tissue structures. As part of the treatment process, he emphasized that kidney tumors may not respond quickly to radiation due to their mitotically inactive natures, as tumors may reflect shrinkage after the first 3 to 6 months of beginning treatment.

Looking towards the future of the field, the experts pointed towards the importance of localized therapies as well as biomarkers to help guide treatment decision-making for those with kidney cancer.

“The local therapies are going to be even more important as we move [around] those nests of resistance and reservoirs of disease. It’s going to happen at every stage of the kidney cancer lifespan, even more so because it’s [not always] the fastest growing disease,” Tang said. “It will be exciting to do that and get biomarkers [that] tell us when we’re doing it correctly.”

Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY^®. Tang is an associate professor in the Department of Genitourinary Radiation Oncology of the Division of Radiation Oncology at The University of Texas MD Anderson Cancer Center.