A look at the evolving HIF2⍺ niche

In the evolving landscape of renal cell carcinoma (RCC) treatment, a compelling story is unfolding at the intersection of four key players: Arcus Biosciences, Merck, Exelixis, and AstraZeneca now Gilead have decided to focus on other strategic priorities.

While Merck’s belzutifan (Welireg) blazed the initial trail in HIF2α inhibition, Arcus’s encouraging casdatifan data and partnership with AstraZeneca, plus Exelixis’s strategic positioning with both cabozantinib and zanzalintinib are all setting the stage for what could become a transformative shift in RCC therapy in the future.

Recent data from ASCO GU 2025 not only demonstrates the potential of these approaches individually, but also hints at how their combinations could reshape treatment paradigms.

At the heart of these developments are a series of critical and provocative questions, which will need to be addressed before we see a winner emerge…

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