Fibroblast growth factor receptor (FGFR) 2 gene alterations can occur in the pathogenesis of cholangiocarcinoma. Pemigatinib (PemazyreTM, Incyte Corporation), a newly FDA approved oral inhibitor of FGFR2, has shown efficacy in patients with previously treated, locally advanced, or metastatic cholangiocarcinoma with and without FGFR2 gene alterations. Approval was granted based a study led by Ghassan Abou-Alfa, MD, MBA from Memorial Sloan Kettering Cancer Center. In an interview with i3 Health, Dr. Abou-Alfa provides insights on treating cholangiocarcinoma, comments on the significance of the pemigatinib approval, and gives advice to community oncologists.
What are the most challenging aspects of treating patients with locally advanced or metastatic, previously treated cholangiocarcinoma?
Ghassan Abou-Alfa, MD, MBA: Patients with locally advanced or metastatic, previously treated cholangiocarcinoma are in need of more effective therapies that would go beyond the standard chemotherapy interventions.
Can you comment on the significance of the approval of pemigatinib for patients with cholangiocarcinoma?
Dr. Abou-Alfa: In the phase 2 study of pemigatinib for previously treated, locally advanced or metastatic cholangiocarcinoma patients, thirty-eight (35.5% [95% CI 26.5-45.4]) of patients with FGFR2 fusions or rearrangements achieved an objective response. Patients with FGFR2 fusions and rearrangements, who make up about 10-16% of patients with cholangiocarcinoma, now have a specific, effective therapy they can benefit from.
Do you have any advice for community oncologists who treat this patient population?
Dr. Abou-Alfa: Please make sure you test patients for next generation sequencing and suggest to do it as soon as possible! It is strongly recommended to reach out to our surgery, gastroenterology, and interventional radiology colleagues to ensure tissue is obtained and tested for next generation sequencing at initial presentation.
About Dr. Abou-Alfa
Ghassan Abou-Alfa, MD, MBA is an Attending Physician at Memorial Sloan Kettering Cancer Center (MSK) and Professor of Medicine at Weill Medical School at Cornell University. Dr. Abou-Alfa served as Chair of the National Cancer Institute (NCI) Hepatobiliary Task Force from 2013-2020 and is member of the NCI AIDS Malignancy Consortium Steering Committee. Dr. Abou-Alfa is the President for the International Society of Gastrointestinal Oncology and is a trustee of the American University of Beirut.
For More Information
Abou-Alfa G, Sahai V, Hollebecque A, et al (2020). Pemigatinib for previously treated, locally advanced or metastatic cholangiocarcinoma: a multicenter, open-label, phase 2 study. Lancet Oncol. [Epub ahead of print] DOI:101016/S1470-2045(20)30109-1
Clinicaltrials.gov (2020). Efficacy and safety of pemigatinib in subjects with advanced/metastatic or surgically unresectable cholangiocarcinoma who failed previous therapy (FIGHT-202). NLM Identifier: NCT02924376
Pemazyre™ (pemigatinib) prescribing information (2020). Incyte Corporation. Available at: https://www.pemazyre.com/?utm_source=google&utm_medium=cpc&utm_campaign=Branded_Pemazyre_DTC_Exact_%3BS%3BPH%3BBR%3BONC%3BDTC%3BB
Image Courtesy of Memorial Sloan Kettering Cancer Center
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of i3 Health.