Conquering Urothelial Carcinoma With FGFR Inhibitors: Moving Toward Personalized Medicine

Conquering Urothelial Carcinoma With FGFR Inhibitors: Moving Toward Personalized Medicine

Med-IQ Select
Online Course | Specialties: Oncology, Pathology, Urology
Released: 12/22/2020
Expires: 12/21/2021
Max Credits: 0.5
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Sumanta K. Pal, MD
Clinical Professor, Department of Medical Oncology & Therapeutics Research
Co-Director, Kidney Cancer Program
City of Hope National Medical Center
Duarte, CA

Activity Planners
Jaime Symowicz, PhD
Manager, Educational Strategy and Content
Baltimore, MD

Rebecca L. Julian, MS, ELS
Senior Manager, Editorial
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Kathryn Schaefer, MSN, RN, CPHRM
Associate Director, Education Quality and Compliance
East Lansing, MI

Haifa Kassis, MD
West Roxbury, MA

Learning Objectives
Upon completion, participants should be able to:

  • Summarize the clinical significance of FGFR alterations in UC pathogenesis
  • Integrate the latest clinical data regarding the efficacy and safety of FGFR inhibitors into practice as these agents become available in UC to facilitate patient counseling and evidence-based care

Target Audience
This activity is intended for oncologists, urologists, pathologists, surgeons, nurse practitioners, physician assistants, and nurses.

Statement of Need
Despite recent therapeutic advances, urothelial cancer (UC) remains difficult to treat and is associated with a poor prognosis. Platinum-based chemotherapy has been the cornerstone of first-line treatment in advanced disease, and immune checkpoint inhibitors have been shown to have activity in both the first-line and recurrent treatment settings. However, many patients do not respond to these therapies, and additional treatment options are limited. Among these patients, fibroblast growth factor receptor (FGFR) alterations have been identified as key oncogenic drivers, which has led to the development of novel selective FGFR tyrosine kinase inhibitors for the treatment of UC. Several FGFR inhibitors have been shown to achieve positive responses, and 1 treatment recently received FDA approval. Therefore, oncology clinicians need to recognize the clinical significance of FGFR aberrations and become familiar with current and emerging FGFR inhibitors to incorporate these therapies into clinical practice in a safe and appropriate manner as they become available.

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Provided by Med-IQ.

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Med-IQ designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Medium/Method of Participation
This is a 0.5-credit CME/CE activity. To receive credit, read the introductory CME/CE material, complete all of the modules, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: December 22, 2020
Expiration Date: December 21, 2021
Estimated Time to Complete This Activity: 30 minutes

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Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Sumanta K. Pal, MD
Consulting fees/advisory boards: Astellas Pharma US Inc., Aveo, Bristol-Myers Squibb, Eisai Inc., Exelixis, Inc., F. Hoffmann-La Roche Ltd., Genentech, Ipsen, Novartis Pharmaceuticals Corporation, Pfizer, Inc.

Haifa Kassis, MD, has indicated no real or apparent conflicts.

The peer reviewers and activity planners have no financial relationships to disclose.

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Acknowledgment of Commercial Support
This activity is supported by an educational grant from QED Therapeutics.

© 2020 Med-IQ, Inc.


Here are some key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available by clicking the "Continue" button below.

  • Alterations in the FGFR signaling pathway, especially those in FGFR3, have been observed in bladder cancers of all grades and stages
  • Patients with luminal I subtype disease are more likely to have FGFR alterations and, subsequently, a poor response to immune checkpoint inhibitor treatment following progression or recurrence after platinum-based chemotherapy treatment
  • The first FGFR inhibitors developed for UC treatment were nonselective in that they targeted several other tyrosine kinases and had a limited clinical response and high toxicity profile
  • Erdafitinib was the first selective FGFR tyrosine kinase inhibitor approved for the treatment of locally advanced or metastatic UC with susceptible FGFR3 or FGFR2 genetic alterations that has progressed during or following platinum-containing chemotherapy
  • Other selective FGFR tyrosine kinase inhibitors are currently under investigation for the treatment of UC including infigratinib, rogaratinib, and vofatamab
  • These selective FGFR inhibitors have been associated with a favorable clinical response, with improvements in progression-free survival and overall survival observed in patients with UC; common adverse effects include hyperphosphatemia, fatigue, diarrhea, stomatitis, and skin and nail toxicities
  • The NCCN guidelines now recommend molecular testing for patients with stage IV UC, and considering it for those with stage IIIB disease, at the time of diagnosis that also includes an analysis for FGFR3 and FGFR2 genetic alterations

View reference list.

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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