Dr. W. Marston Linehan’s urologic oncology group at the U.S. National Institutes of Health has opened a new clinical trial with a drug called AZ6474 from Astra Zeneca, another angiogenesis inhibitor. AZ6474 inhibits VEGF and EGFR.*

The goal of this trial is to determine whether kidney tumors in VHL respond to this drug. Ideally, tumors would shrink or disappear.

In order to qualify for this trial, you must have at least one measurable kidney tumor, but not one that needs immediate surgery. If your tumor is at or greater than 3 cm, you would be advised to have it treated surgically first, as response to this drug would not be expected to be swift enough to prevent the spread of the cancer.

It is assumed that people with VHL will have more than just one tumor, and probably in multiple organ systems. The team will watch all tumors to see if they respond to the drug, but the primary focus of the trial is on kidney tumors.

If you are interested in applying for this trial, please contact Sally Fowler, RN, at +1-301-435-6255.

This group’s earlier trial with 17AAG (Geldanamycin ) has slowed down because of problems getting sufficient quantities of the drug, and also because of the difficulty of administering the drug. 17AAG has to be infused; AZ6474 is a pill

Dr. Linehan expects to try a series of drugs alone and in combination, in hopes of finding an effective treatment with minimal side effects.

Further details will be posted on vhl.org/trials and clinicaltrials.gov.

* Note: Vascular endothelial growth factor (VEGF) and epithelial growth factor receptor (EGFR) are two of the elements in the angiogenesis pathway of which VHL is a key component. While early studies seemed to indicate that inhibiting VEGF would be sufficient to constrain tumors, it seems now that it will be necessary to attack the problem from multiple directions at the same time.