Targeting HIF-2 Alpha in Renal Cell Carcinoma

Curr Treat Options Oncol. 2023 Sep;24(9):1183-1198. doi: 10.1007/s11864-023-01106-y. Epub 2023 Jul 5.

Abstract

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 2α (HIF-2α) has been identified as a rationale target for mRCC treatment. Indeed, one such agent (belzutifan) is already approved for VHL-associated RCC and other VHL-associated neoplasms. Early trials of belzutifan indicate encouraging efficacy and good tolerability in sporadic mRCC as well. The potential inclusion of belzutifan and other HIF-2α inhibitors into the mRCC treatment armamentarium either as a single agent or as combination therapy would be a welcome addition for patients with mRCC.

Keywords: Belzutifan; HIF-2α; Kidney cancer; MK-6482; Renal cell carcinoma; VHL.

Publication types

  • Review

MeSH terms

  • Basic Helix-Loop-Helix Transcription Factors
  • Carcinoma, Renal Cell* / drug therapy
  • Carcinoma, Renal Cell* / etiology
  • Carcinoma, Renal Cell* / metabolism
  • Humans
  • Kidney Neoplasms* / drug therapy
  • Kidney Neoplasms* / etiology
  • Kidney Neoplasms* / metabolism
  • Vascular Endothelial Growth Factor A

Substances

  • endothelial PAS domain-containing protein 1
  • Vascular Endothelial Growth Factor A
  • belzutifan
  • Basic Helix-Loop-Helix Transcription Factors