First- and Second-Line Treatment Options for Intrahepatic Cholangiocarcinoma With FGFR2 Fusions or Alterations

EP: 1.Intrahepatic Cholangiocarcinoma Overview

EP: 2.Risk Factors Leading to Various Liver Cancers

EP: 3.Clinical Presentations of Patients With Cholangiocarcinoma

EP: 4.The Role of Biomarker Testing in Diagnosing Cholangiocarcinoma

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EP: 5.First- and Second-Line Treatment Options for Intrahepatic Cholangiocarcinoma With FGFR2 Fusions or Alterations

EP: 6.Next-Gen Inhibitors Shaping Cholangiocarcinoma Treatment Landscape

EP: 7.Key Highlights For Patient Education Surrounding FGFR Inhibitors

EP: 8.Common Adverse Events Associated With FGFRi Therapy

EP: 9.Patient Perspective Regarding FGFRi Adverse Event Profiles

EP: 10.Symptoms Associated With Eye-Related Toxicities Amid FGFRi Therapy

EP: 11.Monitoring and Managing Hyperphosphatemia

EP: 12.Navigating FGFRi Therapy Adverse Effects: Nail Toxicities

EP: 13.FGFRi-Related Stomatitis and Dry Mouth Impacting Patient Quality of Life

EP: 14.Key Takeaways For Treating Patients Diagnosed With Cholangiocarcinoma

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This is a video synopsis/summary of a OncLive Insights involving Lipika Goyal, MD; Chaundra Bishop; R. Katie Kelley, MD; and Caroline Kuhlman, NP.

Kelley stated first-line treatment for advanced cholangiocarcinoma is chemotherapy (gemcitabine/cisplatin) plus immunotherapy (durvalumab/pembrolizumab), regardless of mutation status, based on improved survival over chemotherapy alone. Challenges launching frontline FGFR inhibitor trials have prevented clear data on superiority over chemoimmunotherapy. Thus, chemoimmunotherapy remains standard for now. If patients have chemotherapy contraindications, Kelley would consider off-label FGFR blockade upfront.

For FGFR2-altered cholangiocarcinoma progressing after first-line therapy, Goyal discussed FDA-approved FGFR inhibitors pemigatinib and futibatinib. The pemigatinib trial reported a 35.5% response rate and 7-month progression-free survival in previously treated patients. Since historical second-line chemotherapy response rates are only 5%, this efficacy is encouraging. Futibatinib demonstrated a 42% response rate and 9 months progression-free survival. Both drugs showed favorable safety profiles.

In summary, first-line chemoimmunotherapy remains standard for advanced cholangiocarcinoma. However, 2 FGFR inhibitors have now shown marked efficacy vs historical treatments. Further trials explore these agents in additional lines of therapy and combination regimens.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.