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Orellanine (ONC175) is a first-in-class, kidney-specific toxin being developed by Oncorena for the treatment of advanced or metastatic renal cell carcinoma (mRCC). Originally discovered in mushrooms of the *Cortinarius* genus, orellanine exhibits a unique organ-specific mode of action, selectively targeting and destroying renal epithelial cells. Because the toxin is lethal to healthy kidney tissue, its clinical application is specifically restricted to patients with end-stage kidney disease who are already undergoing chronic hemodialysis and have no remaining functional kidney tissue to preserve. By leveraging this specificity, orellanine aims to eradicate metastatic renal cancer cells that retain the phenotypic characteristics of their renal origin.
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