Prolonged Clinical Benefit with Futibatinib in a Patient with FGFR Inhibitor–Pretreated FGFR2 Fusion–Positive Intrahepatic Cholangiocarcinoma: Case Report

Abstract

Paolo D d’Arienzo,1,* Alan R MacDonald,1,* Virjen Patel,2 Yuk T Ma,3 Rille Pihlak,4 Naureen Starling1,5 1GI Cancers Unit, The Royal Marsden NHS Foundation Trust, London, UK; 2Clinical Radiology Department, The Royal Marsden NHS Foundation Trust, London, UK; 3Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 4Department of Oncology, St Bartholomew’s Hospital, London, UK; 5Division of Clinical Studies, Institute of Cancer Research, London, UK*These authors contributed equally to this workCorrespondence: Naureen Starling, GI Cancers Unit, The Royal Marsden Hospital, 203 Fulham Road, London, SW3 6JJ, United Kingdom, Email [email protected]: Multiple FGFR inhibitors have demonstrated significant activity in pretreated advanced FGFR2 fusion–positive intrahepatic cholangiocarcinoma. The irreversible pan-FGFR inhibitor futibatinib has the potential to overcome acquired resistance to ATP-competitive FGFR inhibitors in a subset of patients. We present a case of prolonged clinical benefit using FGFR inhibitors sequentially, initially an ATP-competitive inhibitor followed by futibatinib upon progression, for a total of 36 months of FGFR-targeting therapy. This case supports sequential FGFR-targeting therapies for FGFR2 fusion–positive cholangiocarcinoma, with futibatinib acting as rescue therapy after failure of ATP-competitive inhibitors.Keywords: cholangiocarcinoma, FGFR inhibitor, targeted therapy, futibatinib

Keywords

• cholangiocarcinoma
• fgfr inhibitor
• targeted therapy
• futibatinib