Bladder cancer: FGFR3 status guides response to platinum therapy

  • Teo MY & al.
  • Eur Urol
  • 1 Aug 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Fibroblast growth factor receptor 3 (FGFR3) alteration is associated with lower responses to platinum-based chemotherapy in patients with muscle-invasive bladder cancer (MIBC).
  • This relationship, however, was not observed in metastatic disease.

Why this matters

  • FGFR3 status can help in treatment decision-making in bladder cancer.

Study design

  • The study included:
    • 72 patients with MIBC treated with cisplatin-based neoadjuvant chemotherapy (NAC).
    • 108 patients with metastatic urothelial carcinoma treated with first-line platinum-based chemotherapy at Memorial Sloan Kettering Cancer Center.
    • 253 patients from The Cancer Genome Atlas (TCGA) bladder cancer cohort.
  • Funding: National Cancer Institute.

Key results

  • NAC cohort:
    • 13% of patients had FGFR3 alteration, none of whom had pathologic complete response; 3 had residual non-MIBC.
    • FGFR3 alteration was associated with shorter recurrence-free survival (RFS; HR, 2.74; P=.044) but not OS.
  • TCGA cohort:
    • Among patients who underwent adjuvant chemotherapy, those with FGFR3 alteration had shorter RFS (HR, 7.27; P<.001>
    • In chemotherapy-naive patients, FGFR3 alteration was associated with longer RFS (P=.0073).
  • Metastatic urothelial carcinoma cohort:
    • FGFR3 alteration was associated with higher rates of pulmonary metastasis (47% vs 30%; P=.024) and extrapelvic lymphadenopathy (75% vs 62%; P=.038).
    • FGFR3 alteration showed no association with survival.

Limitations

  • Retrospective.