Mechanisms of Clinical Resistance to Selective FGFR2 Inhibition by Lirafugratinib

Annals of Oncology | |

Pan-FGFR inhibitors, targeting FGFR1-3 or FGFR1-4, are FDA-approved for FGFR2-driven cholangiocarcinoma. However, acquired resistance and dose-limiting toxicities from systemic FGFR inhibition constrain efficacy. Lirafugratinib (RLY-4008), a first-in-class FGFR2-selective inhibitor with activity against resistance-associated FGFR2 kinase domain mutations, shows promise in patients with FGFR2-altered solid tumors (ReFocus trial, NCT04526106). Defining acquired resistance mechanisms to selective FGFR2 targeting is essential for therapeutic…

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