The panel outlines a clear shift in second-line renal cell carcinoma management, emphasizing that immunotherapy should not be continued after progression and that switching to a different TKI backbone is essential. The discussion highlights emerging data from the LITESPARK-011 trial, where lenvatinib plus belzutifan demonstrated improved response rates, progression-free survival, and durable responses with a manageable safety profile. Clinically, belzutifan offers a unique mechanism with non-overlapping toxicity, though careful monitoring for anemia and hypoxia is required, with proactive use of ESAs and home pulse oximetry. Overall, combining belzutifan with a potent TKI may help bridge early disease control while enabling longer-term benefit, particularly for patients at risk of rapid progression.
Contributors:
Dr. Pedro Barata is a medical oncologist in Cleveland, Ohio and is affiliated with University Hospitals Cleveland Medical Center.
Dr. Bradley McGregor is a medical oncologist at Dana-Farber in Boston.
Dr. Neil Shah is a medical oncologist at Memorial Sloan Kettering Cancer Center.
Dr. Michael Serzan is a medical oncologist at Dana-Farber in Boston.
