FGFR Inhibitors: Best Practices for Managing Treatment and Treatment-Related Adverse Events - Episode 8
Common Adverse Events Associated With FGFRi Therapy
A review of how frequently adverse events from hyperphosphatemia to nail toxicities to stomatitis and more.
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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.
Goyal explained that as pan-FGFR inhibitors, pemigatinib and futibatinib frequently cause hyperphosphatemia due to on-target FGFR1 effects on renal phosphorus wasting and gastrointestinal absorption. Continuous futibatinib dosing leads to a higher incidence than intermittent pemigatinib’s 2 weeks on/1 week off schedule.
Diarrhea (20%-50%) also occurs owing to FGFR4 inhibition. Nail toxicities like brittleness, breakage, and perionychia arise in 20% to 60% of patients. Ophthalmic issues include blurry vision (3%-24%), prompting baseline and ongoing eye exams to monitor for retinal detachment and central serous retinopathy risks. Mouth sores (stomatitis) arise in 7% to 58% of patients, while dry mouth/eyes occur in 20% to 45%. Other potential toxicities include rash, hair loss (20%-50%), and hand-foot syndrome (5%-33%).
Kelly has not observed many serious adverse events definitively attributable to FGFR inhibitors. Rare potential hypersensitivity reactions manifesting as grade 3 rashes have occurred. Although theoretic with hyperphosphatemia, clinically significant calcium-phosphorus deposition has not been confirmed. Goyal added rapidly progressive cataracts, arising on/shortly after treatment, to the toxicity profile.
In summary, physicians should counsel patients on hyperphosphatemia, diarrhea, and ocular adverse effect likelihoods with pan-FGFR inhibitors. Most adverse events prove manageable, but impacts can be chronic. While not fully characterized, the role of FGFR signaling in ocular physiology warrants additional investigation regarding associated toxicities.
Video synopsis is AI-generated and reviewed by OncLive® editorial staff.
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