Belzutifan, a novel anti-tumor drug targeting HIF-2α, requires strict adherence to individualized treatment principles to control disease progression and minimize adverse reactions.
Recommended Dosage
Recommended dose: 120 mg orally daily until disease progression or unacceptable toxicity.
Indications: For the treatment of patients with VHL who require treatment for related renal cell carcinoma (RCC), central nervous system (CNS) hemangioblastoma, or pancreatic neuroendocrine tumor (pNET) and do not require immediate surgery.
Dose Adjustment in Renal Impairment
Mild to moderate renal impairment [estimated glomerular filtration rate (eGFR) 30-89 mL/min/1.73 m²]: No dose adjustment required.
Severe renal impairment [estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m²]: No data available. Dosage Adjustment for Hepatic Impairment
Mild Hepatic Impairment [Total bilirubin ≤ Upper Limit of Normal (ULN) and Aspartate Aminotransferase (AST) > Upper Limit of Normal, or Total bilirubin > 1-1.5 times Upper Limit of Normal and AST at any level]: No dose adjustment required.
Moderate to Severe Hepatic Impairment (Total bilirubin > 1.5 times Upper Limit of Normal and AST at any level): No relevant data available.
Adverse Reaction Dosage Adjustment Protocol
Initial Dose Reduction: 80 mg orally daily.
Second Dose Reduction: 40 mg orally daily.
Third Dose Reduction: Permanent discontinuation of treatment.
Dose Adjustment for Adverse Reactions
Anemia
Hemoglobin < 9 g/dL or requiring transfusion: Suspend treatment until hemoglobin recovers to 9 g/dL or above; resume treatment at the reduced dose or discontinue treatment depending on the severity of anemia.
Life-threatening or requiring emergency intervention: Suspend treatment until hemoglobin levels return to 9 g/dL or higher; depending on the situation, resume treatment at a reduced dose or permanently discontinue the medication.
Hypoxemia
Decreased blood oxygen saturation during exercise: Consider suspending treatment until symptoms subside; depending on the severity of hypoxemia, resume treatment at the original dose or a reduced dose.
Decreased blood oxygen saturation at rest or requiring emergency intervention: Suspend treatment until symptoms subside; depending on the severity of hypoxemia, resume treatment at a reduced dose or discontinue the medication.
