FGFR3 Inhibitors for Upper Tract Urothelial Cancer

E. David Crawford, MD, Professor of Urology at the University of California, San Diego, and Editor-in-Chief of Grand Rounds in Urology, interviews Sumanta Kumar Pal, MD, Clinical Professor in the Department of Medical Oncology & Therapeutics Research and Co-Director of the Kidney Cancer Program at City of Hope in Duarte, California, about his recent paper looking at FGFR3 inhibitors for treating upper tract urothelial cancer. Dr. Pal explains that upper tract urothelial cancer, which is both more rare and more aggressive than lower tract urothelial cancers, seems to be enriched in mutations in FGFR3, making FGFR3 inhibition a potentially good treatment for this disease state. While one such inhibitor, erdafitinib, is already approved for treating upper tract urothelial cancer, Dr. Pal suggests that a different inhibitor, infigratinib, has a profile that might lend itself better to clinical practice, with lower incidence of hyperphosphatemia and other side effects. He goes over the results of the initial phase 1 study of infigratinib, noting the 25% response rate and considering different biomarkers as indicators of response. Dr. Pal concludes by introducing the Proof 302 study, a phase 3 trial looking at infigratinib for upper tract urothelial cancer which he hopes urologists will consider signing eligible patients up for.

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