Reference Detail

Ref Type

Journal Article

PMID

(38627238)

Authors

Necchi A, Ramlau R, Falcón González A, Chaudhry A, Todenhöfer T, Tahbaz R, Fontana E, Giannatempo P, Deville JL, Pouessel D, Yoon S, Powles T, Bernat M, Häckl M, Marszewska M, McKernan P, Saulay M, Scaleia F, Engelhardt M, Loriot Y, Siefker-Radtke A, De Santis M

Title

Derazantinib alone and with atezolizumab in metastatic urothelial carcinoma with activating FGFR aberrations.

Journal	Vol	Issue	Date	Pages	Journal Short Title
JNCI cancer spectrum	8	3	2024 Apr 30		JNCI Cancer Spectr

URL

Abstract Text

This Phase 1b/2 study assessed the efficacy in terms of objective response rate (ORR) of the FGFR1/2/3 kinase inhibitor derazantinib as monotherapy or in combination with atezolizumab in patients with metastatic urothelial cancer (mUC) and FGFR1-3 genetic aberrations (FGFR1-3GA).This multicenter, open-label study comprised 5 substudies. In Substudies 1 and 5, patients with mUC with FGFR1-3GA received derazantinib monotherapy (300 mg QD in Substudy 1, 200 mg BID in Substudy 5). In Substudy 2, patients with any solid tumor received atezolizumab 1200 mg every 3 weeks plus derazantinib 200 or 300 mg QD. In Substudy 3, patients with mUC harboring FGFR1-3GA received derazantinib 200 mg BID plus atezolizumab 1200 mg every 3 weeks. In Substudy 4, patients with FGFR inhibitor-resistant mUC harboring FGFR1-3GA received derazantinib 300 mg QD monotherapy or derazantinib 300 mg QD plus atezolizumab 1200 mg every 3 weeks.The ORR for Substudies 1 and 5 combined was 4/49 (8.2%, 95% confidence interval = 2.3% to 19.6%), which was based on 4 partial responses. The ORR in Substudy 4 was 1/7 (14.3%, 95% confidence interval = 0.4% to 57.9%; 1 partial response for derazantinib 300 mg monotherapy, zero for derazantinib 300 mg plus atezolizumab 1200 mg). In Substudy 2, derazantinib 300 mg plus atezolizumab 1200 mg was identified as a recommended dose for Phase 2. Only 2 patients entered Substudy 3.Derazantinib as monotherapy or in combination with atezolizumab was well-tolerated but did not show sufficient efficacy to warrant further development in mUC. Clinicaltrials.gov NCT04045613, EudraCT 2019-000359-15.

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Molecular Profile	Treatment Approach

Gene Name	Source	Synonyms	Protein Domains	Gene Description	Gene Role

Therapy Name	Drugs	Efficacy Evidence	Clinical Trials

Drug Name	Trade Name	Synonyms	Drug Classes	Drug Description

Gene	Variant	Impact	Protein Effect	Variant Description	Associated with drug Resistance

Molecular Profile	Indication/Tumor Type	Response Type	Therapy Name	Approval Status	Evidence Type	Efficacy Evidence	References
FGFR3 act mut	transitional cell carcinoma	no benefit	Derazantinib	Phase Ib/II	Actionable	In a Phase I/II trial (FIDES-02), Derazantinib (ARQ 087) treatment was well tolerated but demonstrated limited efficacy in patients with urothelial carcinoma harboring FGFR1 (n=4), FGFR2 (n=7), or FGFR3 (n=35) mutations or FGFR3 fusions (n=6), with an objective response rate of 8.2% (4/49, all partial responses) and disease control rate of 30.6% (15/49) by independent central review (PMID: 38627238; NCT04045613).	38627238
FGFR3 fusion	transitional cell carcinoma	no benefit	Derazantinib	Phase Ib/II	Actionable	In a Phase I/II trial (FIDES-02), Derazantinib (ARQ 087) treatment was well tolerated but demonstrated limited efficacy in patients with urothelial carcinoma harboring FGFR1 (n=4), FGFR2 (n=7), or FGFR3 (n=35) mutations or FGFR3 fusions (n=6), with an objective response rate of 8.2% (4/49, all partial responses) and disease control rate of 30.6% (15/49) by independent central review (PMID: 38627238; NCT04045613).	38627238
FGFR2 act mut	transitional cell carcinoma	no benefit	Derazantinib	Phase Ib/II	Actionable	In a Phase I/II trial (FIDES-02), Derazantinib (ARQ 087) treatment was well tolerated but demonstrated limited efficacy in patients with urothelial carcinoma harboring FGFR1 (n=4), FGFR2 (n=7), or FGFR3 (n=35) mutations or FGFR3 fusions (n=6), with an objective response rate of 8.2% (4/49, all partial responses) and disease control rate of 30.6% (15/49) by independent central review (PMID: 38627238; NCT04045613).	38627238
FGFR3 fusion	transitional cell carcinoma	no benefit	Atezolizumab + Derazantinib	Phase Ib/II	Actionable	In a Phase I/II trial (FIDES-02), combination treatment with Derazantinib (ARQ 087) and Tecentriq (atezolizumab) was well tolerated but demonstrated limited efficacy in patients with urothelial carcinoma harboring FGFR3 mutations (n=8) or FGFR3 fusions (n=2), with an objective response rate (ORR) of 0% (0/10) and disease control rate of 20.0% (2/10) by independent central review (PMID: 38627238; NCT04045613).	38627238
FGFR3 act mut	transitional cell carcinoma	no benefit	Atezolizumab + Derazantinib	Phase Ib/II	Actionable	In a Phase I/II trial (FIDES-02), combination treatment with Derazantinib (ARQ 087) and Tecentriq (atezolizumab) was well tolerated but demonstrated limited efficacy in patients with urothelial carcinoma harboring FGFR3 mutations (n=8) or FGFR3 fusions (n=2), with an objective response rate (ORR) of 0% (0/10) and disease control rate of 20.0% (2/10) by independent central review (PMID: 38627238; NCT04045613).	38627238
FGFR1 act mut	transitional cell carcinoma	no benefit	Derazantinib	Phase Ib/II	Actionable	In a Phase I/II trial (FIDES-02), Derazantinib (ARQ 087) treatment was well tolerated but demonstrated limited efficacy in patients with urothelial carcinoma harboring FGFR1 (n=4), FGFR2 (n=7), or FGFR3 (n=35) mutations or FGFR3 fusions (n=6), with an objective response rate of 8.2% (4/49, all partial responses) and disease control rate of 30.6% (15/49) by independent central review (PMID: 38627238; NCT04045613).	38627238