FGFR alterations may help guide metastatic UC treatment
medwireNews: Researchers have identified an association between the presence of fibroblast growth factor receptor (FGFR) alterations and an increased risk for progression in people with metastatic urothelial carcinoma (mUC) receiving first-line PD-1 pathway inhibitors.
The findings were presented in a poster by Sarah Fleming (Janssen Research & Development, LLC, Raritan, New Jersey, USA) and colleagues at the 2021 ASCO Annual Meeting.
They explained that “[p]hysicians inconsistently order FGFR tests because little is known about the prognostic value of such tests for clinical outcomes” in the locally advanced or metastatic UC setting, with existing analyses “limited by small sample sizes.”
The researchers therefore drew on a convenience sample of 104 US physicians to provide patient-level data via a standardized questionnaire on 414 people diagnosed and treated for stage IIIB or IV UC between July 2017 and June 2019. The average age of the patients included in the study was 64.5 years and nearly three-quarters (73.9%) were men.
Just over half (52.7%) harbored FGFR alterations, while the remaining 47.3% were wild-type for FGFR. The most common first-line treatment was chemotherapy both in patients with and without alterations (47.2 and 63.2%, respectively), followed by PD-1 or PD-L1 inhibitor given as monotherapy (27.5 and 21.9%) or alongside chemotherapy (11.5 and 12.2%).
Overall, there was no significant difference between the FGFR-altered and wild-type groups with regard to the time from diagnosis to disease progression, reported Fleming and team.
But when the analysis was restricted to patients receiving PD-1 or PD-L1 inhibitor monotherapy, those with FGFR alterations were a significant 2.12-fold more likely to have disease progression relative to their FGFR wild-type counterparts.
No such association was observed among patients who received chemotherapy alone and there was a trend towards an increased risk for progression among those who received chemotherapy in combination with a PD-1 pathway inhibitor.
“The presence of FGFR [alterations] may help guide treatment decision-making in patients with mUC,” commented Fleming et al.
And they concluded: “Further work is warranted to validate these results and determine the optimal sequencing strategy for treating mUC patients with FGFR [alterations].”
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This independent news story was supported by an educational grant from Pfizer and Merck Healthcare KGaA, Darmstadt, Germany