Advanced kidney cancer (RCC) How does WELIREG work?

For adults with advanced kidney cancer (RCC) following PD-1 or PD-L1 and VEGF treatments, WELIREG works differently by targeting HIF-2α, a key driver of tumor growth

Certain types of RCC contain a protein
called von Hippel-Lindau (VHL) that does
not work properly. When this happens, or when the cell is not getting enough oxygen, too much HIF-2α can build up, contributing
to tumor growth.

HIF-2α = hypoxia-inducible factor 2 alpha.


When cell growth is controlled

Cells in the body contain a protein called VHL. When the VHL protein is working normally, and when the cell is getting enough oxygen, VHL helps to break down another protein called
HIF-2α, and contributes to maintaining normal cell growth.


When cell growth is uncontrolled

When the VHL protein is not working, or when a cell is not getting enough oxygen, too much HIF-2α can build up. HIF-2α then moves to the nucleus, the cell's control center, and joins another protein called HIF-1β. This turns on genes that can contribute to uncontrolled cell growth in certain types of RCC.

HIF-1β = hypoxia-induced factor 1 beta.


WELIREG
and tumor growth

WELIREG attaches to HIF-2α. When the VHL protein is not working, or when the cell is not getting enough oxygen, WELIREG prevents HIF-2α from joining HIF-1β in the nucleus.

For certain adults whose kidney cancer has spread (advanced RCC), WELIREG works differently by targeting HIF-2α, a key driver of tumor growth.

What is WELIREG?

WELIREG is a prescription medicine used to treat adults with kidney cancer that has spread (advanced RCC) following treatment with a PD-1 or PD-L1 and VEGF cancer medicines.

It is not known if WELIREG is safe and effective in children.

PD⁠-⁠1 = programmed death receptor⁠-⁠1;
PD⁠-⁠L1 = programmed death⁠-⁠ligand 1;
VEGF = vascular endothelial growth factor.

Important Safety Information

WELIREG may cause serious side effects. WELIREG may cause harm to your unborn baby.

  • A pregnancy test will be done before you start treatment.
  • Birth control methods that contain hormones may not work as well during treatment.
  • Females and males with female partners who can become pregnant should use an effective form of non-hormonal birth control (contraception) during treatment and for 1 week after your last dose.

WELIREG may cause serious side effects, including:

Low red blood cell counts (anemia). Low red blood cell counts are common with WELIREG and can be severe. You may need a blood transfusion if your red blood cell counts drop too low. Your health care provider will do blood tests to check your red blood cell counts before you start and during treatment with WELIREG. Tell your health care provider if you get any symptoms of low red blood cell counts, including tiredness, feeling cold, shortness of breath, chest pain, or fast heartbeat.

Low oxygen levels in your body. WELIREG can cause low oxygen levels in your body that can be severe and may require you to stop treatment with WELIREG, receive oxygen therapy, or be hospitalized. Your health care provider will monitor your oxygen levels before you start and during treatment with WELIREG. Tell your health care provider or get medical help right away if you get symptoms of low oxygen in your body, including shortness of breath or increased heart rate.

Harm to your unborn baby. Treatment with WELIREG during pregnancy can cause harm to your unborn baby.

Females who are able to become pregnant:

  • Your health care provider will do a pregnancy test before you start treatment with WELIREG.
  • You should use an effective form of non-hormonal birth control (contraception) during treatment with WELIREG and for 1 week after your last dose.
  • Birth control methods that contain hormones (such as birth control pills, injections, or transdermal system patches) may not work as well during treatment with WELIREG.
  • Talk to your health care provider about birth control methods that may be right for you during treatment with WELIREG.
  • Tell your health care provider right away if you become pregnant or think you may be pregnant during treatment with WELIREG.

Males with female partners who are able to become pregnant:

  • You should use effective birth control (contraception) during treatment with WELIREG and for 1 week after your last dose.
  • Tell your health care provider right away if your partner becomes pregnant or thinks she is pregnant while you are taking WELIREG.

Before taking WELIREG, tell your health care provider about all of your medical conditions, including if you:

  • have low red blood cell counts (anemia)
  • are pregnant or plan to become pregnant
  • are breastfeeding or plan to breastfeed. It is not known if WELIREG passes into your breast milk. Do not breastfeed during treatment with WELIREG and for 1 week after your last dose.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. WELIREG and certain other medicines can affect each other and cause serious side effects.

The most common side effects of WELIREG in adults with VHL disease include:

  • tiredness
  • increased creatinine (kidney function test)
  • headache
  • dizziness
  • increased blood sugar (glucose) levels
  • nausea

The most common side effects of WELIREG in adults with advanced RCC include:

  • tiredness
  • decreased white blood cells
  • increased creatinine (kidney function test)
  • muscle and joint pain
  • increased liver function tests
  • decreased blood salts (sodium) levels
  • increased blood potassium levels

WELIREG may cause fertility problems in males and females, which may affect your ability to have children. Talk to your health care provider if this is a concern for you.

These are not all of the possible side effects of WELIREG. Call your health care provider for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Medication Guide for WELIREG, including an important warning about harm to an unborn baby, and discuss it with your doctor. The physician Prescribing Information also is available.