Future Sequencing with Belzutifan in Advanced Renal Cell Carcinoma

In this segment on advanced renal cell carcinoma, Dr. Wulff explores how the potential incorporation of belzutifan-based regimens into NCCN recommendations could influence future treatment sequencing. Dr. McGregor and Dr. Geynisman discuss how the addition of a HIF-2α inhibitor may introduce a new mechanism of action into the treatment landscape, potentially altering the current reliance on sequential VEGFR TKI therapies after progression on IO-based combinations. The panel considers where belzutifan-based combinations might fit within existing algorithms, including whether they could be positioned earlier in the treatment course or reserved for later lines. They also highlight the importance of understanding cross-resistance, tolerability, and patient selection when integrating new agents. While perspectives may differ on exact placement, the discussion reflects a shared view that emerging therapies like belzutifan could meaningfully expand sequencing options and further individualize care in advanced renal cell carcinoma.