New England Journal of Medicine · 2023 · 541 citations · 34 references
MedicineOncologyPharmacologyCancer PharmacologyMolecular OncologyTumor ProgressionBiliary Tract CancerCancer ProgressionLiver CancerMetastatic Disease TreatmentTargeted Cancer TherapyCholangiocarcinoma PharmacotherapyCovalent InhibitorsDrug Resistance MutationsFgfr Fusion GenesFibroblast Growth Factor Receptor AlterationsLiver Tumor TherapyMetastatic CholangiocarcinomaResistance-associated Mutations
BACKGROUND: -altered tumors and strong preclinical activity against acquired resistance mutations associated with ATP-competitive FGFR inhibitors. METHODS: rearrangement-positive intrahepatic cholangiocarcinoma and disease progression after one or more previous lines of systemic therapy (excluding FGFR inhibitors). The patients received oral futibatinib at a dose of 20 mg once daily in a continuous regimen. The primary end point was objective response (partial or complete response), as assessed by independent central review. Secondary end points included the response duration, progression-free and overall survival, safety, and patient-reported outcomes. RESULTS: mutations. At a median follow-up of 17.1 months, the median progression-free survival was 9.0 months and overall survival was 21.7 months. Common treatment-related grade 3 adverse events were hyperphosphatemia (in 30% of the patients), an increased aspartate aminotransferase level (in 7%), stomatitis (in 6%), and fatigue (in 6%). Treatment-related adverse events led to permanent discontinuation of futibatinib in 2% of the patients. No treatment-related deaths occurred. Quality of life was maintained throughout treatment. CONCLUSIONS: fusion or rearrangement-positive intrahepatic cholangiocarcinoma, the use of futibatinib, a covalent FGFR inhibitor, led to measurable clinical benefit. (Funded by Taiho Oncology and Taiho Pharmaceutical; FOENIX-CCA2 ClinicalTrials.gov number, NCT02052778.).
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