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FDA Okays New FGFR2 Inhibitor for Cholangiocarcinoma

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In Short: The FDA has approved lirafugratinib (Lyrfigtu), a new FGFR2 inhibitor, for adults with previously treated unresectable, locally advanced, or metastatic cholangiocarcinoma that harbors a fibroblast growth factor receptor 2 (FGFR2) gene fusion or other rearrangement.

Phase II trial of fanregratinib in FGFR2-altered intrahepatic cholangiocarcinoma
YouTube — VJOncology

According to a press release from Elevar Therapeutics, lirafugratinib selectively targets FGFR2, distinguishing it from existing pan-FGFR inhibitors that broadly inhibit FGFR1, FGFR3, and/or FGFR4 in addition to FGFR2.

The approval was based on the single-arm phase 1/2 ReFocus trial involving 116 patients who were new to FGFR2 blockers after prior chemotherapy or chemoimmunotherapy.

YouTube — VJOncology YouTube

Lirafugratinib joins two other FGFR2-targeted tyrosine kinase inhibitors already on the US market: pemigatinib and futibatinib.

In testing, lirafugratinib showed lower rates of adverse events commonly associated with non-selective FGFR inhibitors, such as hyperphosphatemia and diarrhea, at 20.7% and 21.6%, respectively.

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