Posted: Tuesday, October 31, 2023
The use of the pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor erdafitinib in patients with papillary-alone, high-risk, non–muscle-invasive bladder carcinoma with select FGFR alterations who refused or were ineligible for radical cystectomy may improve rates of recurrence-free survival, according to the first results of THOR-2 cohort 1, presented at the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract LBA102). This novel treatment strategy has a toxicity profile similar to that of other FGFR inhibitors, according to James W. Catto, MB, ChB, PhD, FRCS, of the University of Sheffield, United Kingdom, and colleagues.
A total of 73 patients with papillary-alone, high-risk, non–muscle-invasive bladder carcinoma were recruited for the study from cohort 1 of the THOR-2 trial. All patients had disease with select FGFR alterations and refused or were ineligible for radical cystectomy and had received prior treatment with bacillus Calmette-Guérin. Patients were randomly assigned to receive treatment with either erdafitinib (n = 49) or intravesical chemotherapy (n = 24) with gemcitabine or mitomycin C.
The study authors reported a median recurrence-free survival of 11.6 months for patients receiving intravesical chemotherapy, with recurrence-free survival rates of 73% and 41% at 6 and 12 months, respectively. The median recurrence-free survival was not reached for patients receiving erdafitinib, with recurrence-free survival rates of 86% and 77% at 5 and 12 months, respectively. Furthermore, 31% of patients treated with erdafitinib and 4% of patients treated with intravesical chemotherapy experienced grade 3 or 4 treatment-related adverse events. A total of 17 patients treated with erdafitinib developed central serous retinopathy, which resolved in 58% of these patients.
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