Robust Response to Futibatinib in a Patient With Metastatic FGFR-Addicted Cholangiocarcinoma Previously Treated Using Pemigatinib

Authors: Anil K. Rengan MD1 and Crystal S. Denlinger MD1,2
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  • 1 Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, and
  • | 2 National Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania.

Abstract

Futibatinib is a novel FGFR inhibitor currently under investigation as a second-line treatment for locally advanced or metastatic cholangiocarcinoma harboring FGFR2 gene fusions and rearrangements. As FGFR-targeted therapies move into the frontline setting, sequencing of these drugs remains undetermined. To date, no study has investigated the use of futibatinib in the context of pemigatinib resistance. We describe a 50-year-old woman with metastatic FGFR-aberrant intrahepatic cholangiocarcinoma who showed a robust response to futibatinib for 23.6 months, having previously benefited from pemigatinib. Futibatinib was safely used despite her history of decompensated cirrhosis and significant cytopenias. We observed a reduction in CA 19-9 level and a partial radiographic response on futibatinib. Serial next-generation sequencing and cell-free DNA testing proved crucial to making appropriate treatment decisions.

Submitted August 9, 2021; final revision received December 13, 2021; accepted for publication December 14, 2021. Published online April 4, 2022.

Disclosures: Dr. Denlinger has disclosed serving on a data safety monitoring board for Zymeworks; receiving consulting fees from Taiho Oncology, Bristol Meyer Squibb, Merck, Exelixis, Zymeworks, and BeiGene; receiving institutional grant/research support from Amgen, AstraZeneca, Agios Pharmaceuticals, Bristol Myer Squibb, BeiGene, Genmab, Zymeworks, and Sanofi Aventis; serving as a principal investigator for Amgen, Array Biopharma, Agios Pharmaceuticals, Bristol Myer Squibb, BeiGene, Genmab, Zymeworks, and Sanofi Aventis; and receiving writing support from Amgen and Eli Lilly & Co. Dr. Rengan has disclosed not receiving any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Funding: Research reported in this publication was supported by the NCI of the NIH under grant number P30 CA006927.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. None of the funders had any role in the conduct of the study; in the collection, management, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.

Correspondence: Crystal S. Denlinger, MD, National Comprehensive Cancer Network, 3025 Chemical Road, Suite 100, Plymouth Meeting, PA 19462. Email: denlinger@nccn.org
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