Immunotherapy With Checkpoint Inhibitors in FGFR-Altered Urothelial Carcinoma

David J Benjamin; Nataliya Mar; Arash Rezazadeh Kalebasty

doi:10.1177/11795549221126252

Immunotherapy With Checkpoint Inhibitors in FGFR-Altered Urothelial Carcinoma

Clin Med Insights Oncol. 2022 Sep 27:16:11795549221126252. doi: 10.1177/11795549221126252. eCollection 2022.

Authors

David J Benjamin¹, Nataliya Mar², Arash Rezazadeh Kalebasty²

Affiliations

¹ Medical Oncology, Hoag Family Cancer Institute, Newport Beach, CA, USA.
² Division of Hematology and Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine, Orange, CA, USA.

Abstract

The treatment landscape of metastatic urothelial cancer (mUC) remained unchanged for over 30 years until the approval of immune checkpoint inhibitors (ICIs) in 2016. Since then, several ICIs have been approved for the treatment of mUC. In addition, recent molecular characterization of bladder cancer has revealed several subtypes, including those harboring fibroblast growth factor receptor (FGFR) mutations and fusion proteins. Erdafitinib, a pan-FGFR inhibitor, was approved for the treatment of metastatic/advanced UC in 2019. Some available evidence suggests ICI may have inferior response in advanced FGFR+ UC for unclear reasons, but may possibly be related to the tumor microenvironment. Several ongoing trials are evaluating erdafitinib in metastatic/advanced UC including the ongoing phase IB/II NORSE trial combining erdafitinib plus ICI, which may prove to offer a more robust and durable response in patients with FGFR+ metastatic/advanced UC.

Keywords: FGFR; Urothelial carcinoma; bladder cancer; checkpoint inhibitor; erdafitinib; immunotherapy.

Publication types

Review