Dr. Sonpavde on the Safety Profile of Erdafitinib in Bladder Cancer

Guru P. Sonpavde, MD, director, Bladder Cancer, and physician, Dana-Farber Cancer Institute, discusses the safety profile of erdafitinib (Balversa), which was approved by the FDA in April 2019 to treat adult patients with locally advanced or metastatic bladder cancer with an FGFR3 or FGFR2 alteration that has progressed on platinum-containing chemotherapy.

Erdafitinib was shown to be active in a phase II trial at the 2019 ASCO Annual Meeting with an overall response rate of higher than 36% and a median duration of response of around 6 months, explains Sonpadve. However, there are some unique toxicities with this agent, including hypophosphatemia and hand-foot syndrome, both of which were grade 1/2 and manageable.

Eye toxicity involving central serous retinopathy (CSR) and central visual defect were also common in patients who received erdafitinib, says Sonpavde. Many oncologists do not have experience with eye toxicity. Sonpavde recommends enlisting the help of an ophthalmologist to monitor patients at the start of treatment. There should also be testing in the oncology clinic to look for CSR.

Although common, CSR was usually grade 1/2 and was reversed when erdafitinib was stopped, according to Sonpavde. Some patients resumed therapy after the toxicity was resolved. Overall, erdafitinib had manageable toxicity and is a significant advance as the first targeted agent in the urothelial space, concludes Sonpavde.