eprintid: 10123796 rev_number: 19 eprint_status: archive userid: 608 dir: disk0/10/12/37/96 datestamp: 2021-03-12 11:18:30 lastmod: 2022-05-09 13:34:30 status_changed: 2021-03-12 11:18:30 type: article metadata_visibility: show creators_name: Goyal, L creators_name: Kongpetch, S creators_name: Crolley, VE creators_name: Bridgewater, J title: Targeting FGFR inhibition in cholangiocarcinoma ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D19 divisions: G98 divisions: G99 keywords: Cholangiocarcinoma; Receptor, Fibroblast Growth Factor, Type 2; Cancer; Oncogenes; Chronic liver disease note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Cholangiocarcinomas (CCAs) are rare but aggressive tumours of the bile ducts, which are often diagnosed at an advanced stage and have poor outcomes on systemic therapy. Somatic alterations with therapeutic implications have been identified in almost half of CCAs, in particular in intrahepatic CCA (iCCA), the subtype arising from bile ducts within the liver. Among patients with CCA, fibroblast growth factor receptor 2 (FGFR2) fusions or rearrangements occur almost exclusively in iCCA, where they are estimated to be found in up to 10–15% of patients. Clinical trials for selective FGFR kinase inhibitors have shown consistent activity of these agents in previously treated patients with iCCA harbouring FGFR alterations. Current FGFR kinase inhibitors show differences in their structure, mechanisms of target engagement, and specificities for FGFR1, 2, 3 and 4 and other related kinases. These agents offer the potential to improve outcomes in FGFR-driven CCA, and the impact of variations in the molecular profiles of the FGFR inhibitors on efficacy, safety, acquired resistance mechanisms, and patients’ health-related quality of life remains to be fully characterized. The most common adverse event associated with FGFR inhibitors is hyperphosphatemia, an on-target off-tumour effect of FGFR1 inhibition, and strategies to manage this include dose adjustment, chelators, and the use of a low phosphate diet. As FGFR inhibitors and other targeted agents enter the clinic for use in FGFR-driven CCA, molecular testing for actionable mutations and monitoring for the emergence of acquired resistance will be essential. date: 2021-04 date_type: published publisher: Elsevier BV official_url: http://doi.org/10.1016/j.ctrv.2021.102170 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1852671 doi: 10.1016/j.ctrv.2021.102170 lyricists_name: Bridgewater, John lyricists_name: Crolley, Valerie lyricists_id: JABRI52 lyricists_id: VCROL16 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Cancer Treatment Reviews volume: 95 article_number: 102170 citation: Goyal, L; Kongpetch, S; Crolley, VE; Bridgewater, J; (2021) Targeting FGFR inhibition in cholangiocarcinoma. Cancer Treatment Reviews , 95 , Article 102170. 10.1016/j.ctrv.2021.102170 <https://doi.org/10.1016/j.ctrv.2021.102170>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10123796/1/1-s2.0-S0305737221000189-main.pdf