Prevention and treatment of FGFR inhibitor-associated toxicities

Fibroblast growth factor receptor (FGFR) inhibitors have shown promising results in terms of objective response rates in phase I/II trials in various malignancies that harbor FGFR genetic aberrations. The class of medications brings in the concept of 'personalized' treatment by targeting susceptible FGFR genetic alterations in some rare but dismal cancers such as cholangiocarcinoma. Despite the fact that FGFR inhibitors are well-tolerated, these drugs are associated with toxicities that are distinct from that of other small-molecule tyrosine kinase inhibitors. These toxicities can result in dose reductions, interruptions, and even drug discontinuation as reported in the clinical trials. The prevention and effective management of the FGFR inhibitor-associated toxicities will allow patients to stay on these medications without the therapy interruptions. The current work is focused on summarizing the available literature on unique FGFR inhibitor-associated toxicities with a special emphasis in managing the unique adverse events.

Keywords: Cholangiocarcinoma; FGFR; Hyperphosphatemia; Personalized medicine.