Dr. Siefker-Radtke on the Treatment of FGFR-Altered Bladder Cancer

Arlene O. Siefker-Radtke, MD, professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the treatment of patients with bladder cancer who have fibroblast growth factor receptor (FGFR)-altered tumors.

Bladder cancer is no longer seen as 1 disease, Siefker-Radtke says, even though it has been treated as such historically. Recently, different subsets of bladder cancer were discovered that respond to different types of therapy. There are some types that respond to immunotherapy, while there are others that are immunologically “cold” and do not respond to immunotherapy. Siefker-Radtke says that the FDA announced that patients with low PD-L1 expression will no longer be accrued to frontline immunotherapy trials.

FGFR3-altered tumors represent an unmet need in bladder cancer, Siefker-Radtke says. These tumors do not respond well to immunotherapy, and data suggest that they may be immunologically “cold”. In a phase II study of patients with metastatic or unresectable urothelial carcinoma, the FGFR inhibitor erdafitinib showed a 40% response rate in this group of patients. Of 99 patients enrolled on the study, 40 responded to treatment, and an additional 39 patients had stable disease.