Targeted Drug Therapy for Adrenal Cancers

Targeted drugs focus on specific parts of cancer cells. Some targeted drugs might be useful for treating adrenal cancers that are advanced, cannot be removed by surgery, have spread, or have come back after treatment.

Targeted drugs are most often used to treat advanced pheochromocytomas. However, cabozantinib is also used to treat advanced adrenocortical carcinoma.

Learn more about targeted drug therapy to treat neuroblastoma in Targeted Drug Therapy for Neuroblastoma.

Kinase inhibitors

Kinases are proteins in or on cells that send signals to the rest of the cell. Sometimes they can help cells grow. Drugs called kinase inhibitors can help stop or slow the growth of some tumors. Examples of kinase inhibitors that might be used for certain adrenal cancers include:

• Cabozantinib (Cabometyx, Cometriq)
• Sunitinib (Sutent)
• Selpercatinib (Retevmo)

Selpercatinib is useful only if an adrenal cancer has a RET gene fusion.

These medications are taken by mouth as pills, typically once or twice a day.

Side effects of kinase inhibitors

Common side effects of kinase inhibitors include:

• Swelling
• High blood pressure
• Skin rash
• Belly pain
• Nausea
• Constipation or diarrhea
• Low appetite
• Low blood counts
• Low energy
• Muscle or joint pain

These medications can also have rare, but serious side effects. These include liver failure, heart problems, lung problems, bleeding, thyroid problems, and allergic type reactions.

Your care team will monitor you closely. If side effects occur, you might need to take a lower dose or stop the medication.

HIF-2α inhibitor

Belzutifan (Welireg) is a targeted therapy called a hypoxia-inducible factor 2 alpha (HIF-2α) inhibitor. It works by blocking the HIF-2a protein.

This protein normally works with other proteins to increase blood flow when oxygen levels are low. Cancer cells rely on these signals to get the nutrients and oxygen they need to grow. When the signals are blocked, tumor growth may slow or stop.

This drug is especially useful for people who have tumors from von Hippel-Lindau syndrome, but it can be used for some tumors in people without it.

This medication is taken by mouth as a tablet once a day.

Side effects of HIF-2α inhibitors

Side effects of this medication may include:

• Swelling
• Constipation or diarrhea
• Nausea or vomiting
• Low appetite
• Low red blood cell count (anemia)
• Dizziness
• Low energy
• Muscle or joint pain

Your care team will monitor you closely. If side effects occur, you might need to take a lower dose or stop the medication.