4.4 Review

Targeting HIF-2 Alpha in Renal Cell Carcinoma

Journal

CURRENT TREATMENT OPTIONS IN ONCOLOGY
Volume 24, Issue 9, Pages 1183-1198

Publisher

SPRINGER
DOI: 10.1007/s11864-023-01106-y

Keywords

Renal cell carcinoma; HIF-2 alpha; Belzutifan; MK-6482; Kidney cancer; VHL

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Current treatment options for mRCC are limited, and there is a critical need for novel treatment options. HIF-2a has been identified as a target for mRCC treatment and early trials of belzutifan have shown promising efficacy. The inclusion of HIF-2a inhibitors like belzutifan in mRCC treatment would be a welcome addition.
Current treatment options for patients with metastatic renal cell carcinoma (mRCC) are limited to immunotherapy with checkpoint inhibitors and targeted therapies that inhibit the vascular endothelial growth factor receptors (VEFG-R) and the mammalian target of rapamycin (mTOR). Despite significantly improved outcomes over the last few decades, most patients with mRCC will ultimately develop resistance to these therapies, thus highlighting the critical need for novel treatment options. As part of the VHL-HIF-VEGF axis that rests at the foundation of RCC pathogenesis, hypoxia-inducible factor 2a (HIF-2a) has been identified as a rationale target for mRCC treatment. Indeed, one such agent (belzutifan) is already approved for VHL-associated RCC and other VHLassociated neoplasms. Early trials of belzutifan indicate encouraging efficacy and good tolerability in sporadic mRCC as well. The potential inclusion of belzutifan and other HIF-2a inhibitors into the mRCC treatment armamentarium either as a single agent or as combination therapy would be a welcome addition for patients with mRCC.

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