Effects of Belzutifan on 89Zr-DFO-girentuximab PET Uptake in Patients With Renal Cell Carcinoma (RCC)

NCT ID: NCT07179770

Last Updated: 2025-09-23

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE1
• Total Enrollment: 12 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-09-15
• Study Completion Date: 2027-10-01

Brief Summary

The purpose of this study is to identify changes in Carbonic Anhydrase IX (CAIX) expression induced by hypoxia-inducible factor 2 alpha (HIF-2α) inhibition by initiating belzutifan single agent therapy and imaging CAIX expression with 89Zr-DFO-girentuximab PET before and 4 weeks after initiating treatment. This will be the first study to evaluate potential changes in CAIX expression altered by belzutifan. Information gained from this study will be leveraged to develop combinations of belzutifan with CAIX targeted agents including radioimmunotherapy in the future.

Conditions

Metastatic Clear Cell Renal Cell Carcinoma

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Previously treated metastatic clear cell RCC

Patients will undergo imaging with \[89Zr\]Zr-DFO-girentuximab PET before and 28 days after treatment with belzutifan.

Group Type: EXPERIMENTAL

Belzutifan

Intervention Type: DRUG

120 mg orally daily for 28 days

89Zr-DFO-girentuximab

Intervention Type: DRUG

10 mg single slow intravenous (IV) administration

89Zr-DFO-girentuximab PET

Intervention Type: DEVICE

89Zr-DFO-Girentuximab PET before and after 4 weeks of treatment with standard-of-care (SOC) belzutifan.

Interventions

Belzutifan

120 mg orally daily for 28 days

Intervention Type: DRUG

89Zr-DFO-girentuximab

10 mg single slow intravenous (IV) administration

Intervention Type: DRUG

89Zr-DFO-girentuximab PET

89Zr-DFO-Girentuximab PET before and after 4 weeks of treatment with standard-of-care (SOC) belzutifan.

Intervention Type: DEVICE

Other Intervention Names

Welireg®; TLX250-CDx

Eligibility Criteria

Inclusion Criteria

1. Histologically confirmed advanced clear cell RCC

2. Radiographic disease progression to prior immune checkpoint inhibitor (ICI) therapy for RCC

• ICI for adjuvant therapy: Patients who experienced radiographic tumor progression during or within 6 months after last dose of adjuvant ICI
• ICI for locally advanced or metastatic disease: radiographic disease progression during or following ICI treatment in the 1st line setting
• Minimum two previous treatment regimens but no maximum limit

3. Measurable disease per RECIST v1.1

4. Recovery to baseline or Grade1 NCI CTCAE v5.0 from toxicities related to any prior treatments, unless adverse events are clinically nonsignificant and/or stable in the opinion of the investigator.

5. Age>18 years of age

6. Karnofsky performance score ≥60%

7. Patients must have adequate organ and marrow function as defined below:

• absolute neutrophil count ≥1,000/mcL
• platelets ≥100,000/mcL
• total bilirubin ≤ institutional upper limit of normal (ULN)
• Aspartate Aminotransferase (AST) (SGOT)/Alanine Aminotransferase (ALT) (SGPT ≤3 × institutional ULN
• creatinine ≤ institutional ULN OR
• glomerular filtration rate (GFR) ≥60 mL/min/1.73 m2 unless data exists supporting safe use at lower kidney function values, no lower than 30 mL/min/1.73 m2

1. Patients with abnormal test results outside the allowable range, but are not clinically significant, may still enroll with PI's review and approval.

2. Laboratory reference values should account for potential normal variations due to race, ethnicity, age, sex, and gender identity (e.g., due to surgical and/or hormonal changes).

8. Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.

9. For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.

10. Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.

11. Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression.

12. Patients with new or progressive brain metastases (active brain metastases) or leptomeningeal disease are eligible if the treating physician determines that immediate CNS specific treatment is not required and is unlikely to be required during the first cycle of therapy.

13. Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.

14. Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better.

15. Patients who agree to use an adequate method of contraception throughout the study period, starting with the administration of 89Zr-DFO-girentuximab,

16. Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

1. Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities > Grade 1) with the exception of alopecia.

2. Patients who are receiving any other investigational agents.

3. History of allergic reactions attributed to compounds of similar chemical or biologic composition to girentuximab.

4. Patients with uncontrolled intercurrent illness at the discretion of the investigator.

5. Pregnant women are excluded from this study because belzutifan is an agent with the potential for teratogenic or abortifacient effects.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: collaborator

NYU Langone Health

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Minas Economides, MD

Role: PRINCIPAL_INVESTIGATOR

NYU Langone Health

Locations

NYU Langone Health

New York, New York, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Cancer Trials (NYU Langone Health Perlmutter Cancer Center)

Role: CONTACT

CancerTrials@nyulangone.org

212-263-4432

Other Identifiers

5K12CA270377-02

Identifier Type: NIH

Identifier Source: secondary_id

View Link

24-01254

Identifier Type: -

Identifier Source: org_study_id