Fibroblast Growth Factor Receptor (FGFR) Inhibitors for the Treatment of Cholangiocarcinoma: Key Therapeutic Developments and Knowledge Gaps


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Erul E., Cifuentes-Canaval S., Santhosh A., Sokolović E., Della Mura M., Cazzato G., ...Daha Fazla

Drug Design, Development and Therapy, cilt.20, 2026 (SCI-Expanded, Scopus) identifier identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 20
  • Basım Tarihi: 2026
  • Doi Numarası: 10.2147/dddt.s559328
  • Dergi Adı: Drug Design, Development and Therapy
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Directory of Open Access Journals
  • Anahtar Kelimeler: acquired resistance, biliary tract cancer, FGFR inhibitors, FGFR2 alterations, intrahepatic cholangiocarcinoma, liquid biopsy
  • Ankara Üniversitesi Adresli: Evet

Özet

Fibroblast growth factor receptor 2 (FGFR2) alterations have emerged as an important targetable oncogenic driver in a biologically distinct subset of biliary tract cancers (BTCs), particularly intrahepatic cholangiocarcinoma (iCCA), alongside other actionable genomic events such as IDH1 mutations, BRAF V600E, HER2 amplification and MSI-H. FGFR2 fusions and mutations define a distinct molecular subgroup whose prevalence varies across geographic regions and etiologic backgrounds such as liver fluke–associated disease. Clinical studies of both reversible and irreversible FGFR inhibitors have demonstrated meaningful activity in FGFR2-rearranged iCCA, while also highlighting a characteristic toxicity profile dominated by on-target hyperphosphataemia. Parallel translational work using cfDNA-based liquid biopsy has mapped a spectrum of secondary kinase-domain mutations that underlie acquired resistance, informing the development of next-generation FGFR2-selective inhibitors (eg, lirafugratinib) and combination strategies with EGFR/ERBB blockade. Collectively, these data underscore the need for comprehensive molecular profiling and innovative umbrella trial designs to optimise targeted therapy in this rare, biologically heterogeneous malignancy.