Belzutifan

FDA approves belzutifan for cancers associated with von Hippel-Lindau disease

From FDA website information

On August 13, 2021, the Food and Drug Administration approved belzutifan (Welireg, Merck), a hypoxia-inducible factor inhibitor for adult patients with von Hippel-Lindau (VHL) disease who require therapy for associated renal cell carcinoma (RCC), central nervous system (CNS) hemangioblastomas, or pancreatic neuroendocrine tumors (pNET), not requiring immediate surgery.

Belzutifan was investigated in the ongoing Study 004 (NCT03401788), an open-label clinical trial in 61 patients with VHL-associated RCC (VHL-RCC) diagnosed based on a VHL germline alteration and with at least one measurable solid tumor localized to the kidney. Enrolled patients had other VHL-associated tumors, including CNS hemangioblastomas and pNET. Patients received belzutifan 120 mg once daily until disease progression or unacceptable toxicity.

The primary efficacy endpoint was overall response rate (ORR) measured by radiology assessment, as assessed by an independent review committee using RECIST v1.1. Additional efficacy endpoints included duration of response (DoR), and time- to- response (TTR). An ORR of 49% (95% CI:36, 62) was reported in patients with VHL-associated RCC. All patients with VHL-RCC with a response were followed for a minimum of 18 months from the start of treatment. The median DoR was not reached; 56% of responders had DoR ≥ 12 months and a median TTR of 8 months. In patients with other VHL-associated non-RCC tumors, 24 patients with measurable CNS hemangioblastomas had an ORR of 63% and 12 patients with measurable pNET had an ORR of 83%. Median DoR was not reached, with 73% and 50% of patients having response durations ≥ 12 months for CNS hemangioblastomas and pNET, respectively.

The most common adverse reactions, including laboratory abnormalities, reported in ≥ 20% of patients who received belzutifan were decreased hemoglobin, anemia, fatigue, increased creatinine, headache, dizziness, increased glucose, and nausea. Anemia and hypoxia from belzutifan use can be severe. In Study 004, anemia occurred in 90% of patients and 7% had Grade 3 anemia. Patients should be transfused as clinically indicated. The use of erythropoiesis stimulating agents for treatment of anemia is not recommended in patients treated with belzutifan. In Study 004, hypoxia occurred in 1.6% of patients. Belzutifan can render some hormonal contraceptives ineffective, and belzutifan exposure during pregnancy can cause embryo-fetal harm.

The recommended belzutifan dosage is 120 mg administered orally once daily with or without food.

FDA批准倍祖替芬belzutifan用于治疗与von Hippel-Lindau病相关的癌症

FDA信息

2021年8月13日，美国食品和药物管理局批准belzutifan（倍祖替芬，Merck），一种缺氧诱导因子抑制剂，用于治疗成年von Hippel-Lindau（VHL）病患者[伴有肾细胞癌（RCC）、中枢神经系统（CNS）血管母细胞瘤或胰腺神经内分泌肿瘤（pNET），不需要立即手术]。 推荐的belzutifan剂量为120毫克，每天一次，可与或不与食物一起口服。患者接受belzutifan 120毫克，每天一次，直到疾病进展或出现不可接受的毒性。

在接受belzutifan的患者中，报告的最常见的不良反应（包括实验室异常）是血红蛋白降低、贫血、疲劳、肌酐升高、头痛、头晕、葡萄糖升高和恶心。使用belzutifan引起的贫血和缺氧可能很严重。在004号研究中，90%的患者出现贫血，7%的患者出现3级贫血。患者应根据临床需要进行输血。不建议在接受belzutifan治疗的患者中使用促红细胞生成剂来治疗贫血。在004号研究中，1.6%的患者发生缺氧。Belzutifan可使某些荷尔蒙避孕药失效，怀孕期间接触belzutifan可导致胚胎-胎儿伤害。