#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 9/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 7👨🏽‍🏫 LT-005 enrolled ~740 patients, despite of VHL status 🎲 1:1 everolimus 🥊 belzutifan 🥅 1o. EP of PFS / OS. ⬆️PFS at 18 mo. (24% vs 8%, p < 0.05) ❤️ OS of 21.4 vs 18.1 mo (ns).

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 10/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 8👨🏽‍🏫 🩻Best ORR (~22% vs. 3.5%) ⏱️mTTR of 3.8 vs 3.7 mo. ⌛️mDoR of 19.5 vs 13.7 mo. 🚨34% had early PD with belzu.

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday When I use everolimus for NETs, it can be kind of hard to tolerate. Do you all the same experience in RCC❓

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 11//17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 9👨🏽‍🏫 HIFi causes ⬇️ EPO, anemia🩸 most common AE, G3 ~33% 🫁 Hypoxia, AE of interest (G3 ~11%), mechanism is unclear. ⏱️Median time for both AEs ~ 1 month. 🔡 Mgmt: 💉 ESAs (anemia), oxygen (hypoxia), and ⬇️ dose.

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 12/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 10👨🏽‍🏫 Despite ~62% grade 3-5 AE in both arms Belzu had ⬇️ tx related discontinuation (~6% vs 15%) Different safety profile ( ⬇️rash, stomatitis, hyperglycemia, pneumonitis)

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday Any🧬🔬biomarkes that predict for response/benefit from belzutifan❓

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 13/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 11👨🏽‍🏫 🆕 🎯 💊 belzutifan-based combinations are being tested in refractory RCC

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday Any concerns about adding an ESA with an active malignancy (RCC)❓ ⚖️Or is it just a risk-benefit decision❓

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 14/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 12👨🏽‍🏫 A ph3 trial is testing a HIFi ➕TKI vs. TKI monotherapy post-IO tx.

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday Hmmm - it seems like the lenvatinib is doing the bulk of the work here?

Mike Pishvaian #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers So far, we do not have an biomarker that predicts responde to belzutifan

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 15/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 13👨🏽‍🏫 🆕Prospective randomized trials are needed. LITESPARK-012 is testing triplets regimens in frontline Arm A using IO ➕ TKI ➕ belzu.

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 16/17 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 14👨🏽‍🏫 🎉 New HIFis, like Casdatifan, are on the way ORR ~33% on 100 mg QD PEAK-1 trial (CAS + CABO vs. CABO + PBO)

Paulo Amaral, MD #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #TumorBoardTuesday What's the toxicity of belzutifan + lenva? Lenvatinib can also be tough to tolerate (especially for HCC patients). Wonder how much the belza adds to this?

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers 17/17 #TumorBoardTuesday 🔙 to our case📷Our pt s/p PD IO-TKI, PR w/ belzu, w/ & tolerance. 📷Pt selection consider: 📷 disease volume, 📷organ function, 📷toxicities 📷 Attention to anemia and hypoxia.🤮🔙‼️

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #PostTest Q1️⃣ #TumorBoardTuesday 👉🏽#CME Eval 🔗 integrityce.com/TBTeval25 👉🏽ALL CME🔗 integrityce.com/TBT2025 🧠 70-year-old mccRCC pt progressed on axi + pembro → cabo. Next?

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers #PostTest Q2️⃣ #TumorBoardTuesday 👉🏽 Free CME 🔗 integrityce.com/TBT2025 Most common belzutifan-related AEs & median onset in RCC?

#TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers David Muniz

Mike Pishvaian #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers Once decreased EPO is the reason for anemia, EPO replacement was encouraged in LT-005 protocol. However safety analysis is still lacking. In clinical practice, it seems to be safe enough.

Mike Pishvaian #TumorBoardTuesday Brian Rini, MD Integrity CE, LLC Rana McKay, MD, FASCO Sumanta K. Pal, MD, FASCO Katy Beckermann Joseph Vento, MD, MS Miguel Zugman Toni Choueiri, MD Tom Powles Tian Zhang, MD, MHS KidneyCAN 𝐂𝐡𝐚𝐧𝐝𝐥𝐞𝐫 𝐏𝐚𝐫𝐤 𝐌𝐃 𝐅𝐀𝐂𝐏 jc Alan Tan Uromigos Laurence Albiges Andrey Soares Sahil Doshi Gabriel Aleixo James Brugarolas Yu-Wei Chen, MD, MS Hans Hammers Hard to tolerate and low efficacy...