Belzutifan for Kidney Cancer

Recruiting at 3 trial locations

Overseen By Toll Free Number

Age: 18+

Sex: Any

Trial Phase: Phase 1

Sponsor: Merck Sharp & Dohme Corp.

Must not be taking: Anticancer antibodies

Disqualifiers: Hypoxia, Brain metastasis, Cardiac disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: Up to ~48.5 months

52 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial is testing belzutifan, a medication for patients with advanced kidney cancer that hasn't responded to previous treatments. The drug works by blocking a protein that cancer cells need to grow. Researchers aim to find out if it is safe and effective for these patients. Belzutifan has received FDA approval for treating von Hippel-Lindau-associated renal cell carcinoma and has shown significant efficacy in related tumors.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, it mentions that you should not have received certain treatments like systemic anticancer antibodies or radiotherapy shortly before starting the study. It's best to discuss your specific medications with the trial team.

What data supports the effectiveness of the drug Belzutifan for kidney cancer?

Research shows that Belzutifan, when combined with other drugs like cabozantinib or lenvatinib, has shown promising results in treating advanced kidney cancer, especially in patients who have already received other treatments. It has demonstrated antitumor activity, meaning it can help shrink or slow the growth of tumors in these patients. ^{1 2 3 4 5}

How is the drug Belzutifan unique for treating kidney cancer?

Belzutifan is unique because it targets a specific protein called HIF-2α, which plays a role in the growth of kidney cancer cells, offering a novel approach compared to other treatments that often target different pathways. ^{6 7 8 9 10}

Research Team

Medical Director

Principal Investigator

Merck Sharp & Dohme LLC

Eligibility Criteria

This trial is for adults with advanced clear cell renal cell carcinoma who've had disease progression after at least one systemic treatment. They must have good organ function, agree to use contraception, and not be pregnant or breastfeeding. Exclusions include those with hypoxia, other active cancers within 3 years (except certain skin/in situ cancers), HIV/hepatitis infections, prior belzutifan treatment, recent anticancer antibodies or radiotherapy, major surgery within 3 weeks, brain metastasis, severe heart/liver conditions or infections.

Inclusion Criteria

My kidney cancer cannot be surgically removed and has spread.

My organs are functioning well.

My kidney cancer has worsened after at least one treatment.

Exclusion Criteria

I have not taken any CSFs within the last 28 days.

I have been treated with belzutifan before.

I have a history of GI issues or liver problems.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive escalating doses of belzutifan as second line treatment for advanced clear cell renal cell carcinoma

Up to ~48.5 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Belzutifan

Trial Overview The study tests the safety and effects of different doses of Belzutifan in patients with advanced kidney cancer as a second-line treatment. It aims to understand how the body handles the drug (pharmacokinetics) and its tolerability when given after another therapy has failed.

Participant Groups

Group I: Belzutifan 200 mg TID Experimental Treatment 1 Intervention

Participants will receive belzutifan 200 mg orally TID. Treatment will continue until progressive disease or discontinuation.

Group II: Belzutifan 160 mg TID Experimental Treatment 1 Intervention

Participants will receive belzutifan 160 mg orally three times daily (TID). Treatment will continue until progressive disease or discontinuation.

Group III: Belzutifan 160 mg BID Experimental Treatment 1 Intervention

Participants will receive belzutifan 160 mg orally twice daily (BID). Treatment will continue until progressive disease or discontinuation.

Group IV: Belzutifan 120 mg QD Experimental Treatment 1 Intervention

Participants will receive belzutifan 120 mg orally once daily (QD). Treatment will continue until progressive disease or discontinuation.

Belzutifan is already approved in United States for the following indications:

Approved in United States as Welireg for:

• Advanced renal cell carcinoma (RCC) following a PD-1 or PD-L1 inhibitor and a VEGF TKI
• Von Hippel-Lindau disease-associated RCC, central nervous system hemangioblastomas, or pancreatic neuroendocrine tumors

Who Is Running the Clinical Trial?

Merck Sharp & Dohme Corp.

Lead Sponsor

Trials

2,287

Recruited

4,582,000+

Chirfi Guindo

Merck Sharp & Dohme Corp.

Chief Medical Officer

Engineering degree from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis

Merck Sharp & Dohme Corp.

Chief Executive Officer since 2021

J.D. from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Merck Sharp & Dohme LLC

Lead Sponsor

Trials

4,096

Recruited

5,232,000+

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Findings from Research

The combination of belzutifan and cabozantinib shows promising antitumor activity in patients with advanced clear cell renal cell carcinoma who have already undergone previous treatments.

This study highlights the potential of this drug combination as a new therapeutic option for patients with this challenging form of kidney cancer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Belzutifan Plus Cabozantinib Is Effective in Immunotherapy-Treated Renal Cell Carcinoma. [2023]

Belzutifan, a first-in-class HIF-2α inhibitor, shows promising antitumor activity in patients with clear cell renal cell carcinoma (RCC) who have previously been treated, indicating its potential as a new treatment option.

The ongoing phase III study is comparing the combination of belzutifan with lenvatinib against cabozantinib in patients with advanced RCC who have progressed after anti-PD-1/PD-L1 therapy, addressing a significant need for effective treatments in this patient population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

LITESPARK-011: belzutifan plus lenvatinib vs cabozantinib in advanced renal cell carcinoma after anti-PD-1/PD-L1 therapy. Motzer, RJ., Schmidinger, M., Eto, M., et al.[2023]

The HIF-2α inhibitor, belzutifan, has shown effectiveness in treating advanced clear-cell renal cell carcinoma in the LITESPARK-005 and -003 trials, both as a standalone treatment and in combination with VEGFR tyrosine kinase inhibitors.

These promising results suggest that belzutifan could be used more broadly in cancer treatment, potentially extending its application beyond just von Hippel-Lindau disease-associated cancers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Expanding "Practice-Changing" Belzutifan's Reach in RCC. [2023]

In a phase 2 study involving 52 patients with advanced clear cell renal cell carcinoma who had previously received immunotherapy, the combination of belzutifan and cabozantinib showed promising antitumour activity, with 30.8% of patients achieving a confirmed objective response, including one complete response.

The treatment was associated with manageable safety concerns, primarily hypertension (27% of patients), and serious treatment-related adverse events occurred in 29% of patients, indicating that while the combination therapy is effective, careful monitoring for side effects is necessary.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Belzutifan plus cabozantinib for patients with advanced clear cell renal cell carcinoma previously treated with immunotherapy: an open-label, single-arm, phase 2 study. Choueiri, TK., McDermott, DF., Merchan, J., et al.[2023]

Belzutifan (Welireg™) is an oral medication that inhibits HIF-2α and has been approved in the USA for treating patients with von Hippel-Lindau (VHL) disease who have associated renal cell carcinoma (RCC) and other tumors, marking a significant advancement in targeted cancer therapy.

Clinical studies are ongoing to evaluate the efficacy of belzutifan in treating other solid tumors, including clear cell renal cell carcinoma (ccRCC) and pancreatic neuroendocrine tumors (pNET), indicating its potential for broader applications in oncology.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Belzutifan: First Approval. Deeks, ED.[2022]

The combination of sorafenib, gemcitabine, and capecitabine is tolerable for patients with advanced renal cell carcinoma, with a recommended phase II dose established to minimize side effects like hand-foot syndrome.

Out of 15 patients treated, 29% showed a partial response to the therapy, and the median progression-free survival was 7.5 months, indicating potential effectiveness of this treatment regimen.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A phase I trial of sorafenib plus gemcitabine and capecitabine for patients with advanced renal cell carcinoma: New York Cancer Consortium Trial NCI 6981. Tagawa, ST., Milowsky, MI., Jeske, S., et al.[2022]

Novel targeted therapies, such as sunitinib, sorafenib, and temsirolimus, have significantly improved clinical outcomes for patients with metastatic clear cell renal cell cancer compared to traditional cytokine treatments.

The development of these therapies, which target the vascular endothelial growth factor and mTOR pathways, suggests a promising future for renal cancer treatment, with ongoing evaluations of combination therapies to enhance efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Targeted therapy for renal cell carcinoma: a new treatment paradigm. Hutson, TE.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Belzutifan Plus Cabozantinib Is Effective in Immunotherapy-Treated Renal Cell Carcinoma. [2023]

2. England pubmed.ncbi.nlm.nih.gov

LITESPARK-011: belzutifan plus lenvatinib vs cabozantinib in advanced renal cell carcinoma after anti-PD-1/PD-L1 therapy. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Expanding "Practice-Changing" Belzutifan's Reach in RCC. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Belzutifan plus cabozantinib for patients with advanced clear cell renal cell carcinoma previously treated with immunotherapy: an open-label, single-arm, phase 2 study. [2023]

5. New Zealand pubmed.ncbi.nlm.nih.gov

Belzutifan: First Approval. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

A phase I trial of sorafenib plus gemcitabine and capecitabine for patients with advanced renal cell carcinoma: New York Cancer Consortium Trial NCI 6981. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Targeted therapy for renal cell carcinoma: a new treatment paradigm. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Sorafenib: recent update on activity as a single agent and in combination with interferon-alpha2 in patients with advanced-stage renal cell carcinoma. [2019]

9. Australia pubmed.ncbi.nlm.nih.gov

Efficacy of sorafenib in advanced renal cell carcinoma independent of prior treatment, histology or prognostic group. [2018]

10. England pubmed.ncbi.nlm.nih.gov

Experience with sorafenib in the treatment of advanced renal cell carcinoma. [2021]