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PEER-TO-PEER CLINICAL CONVERSATIONS
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The Association Between FGFR3 Alterations and Response to Platinum-Based Chemotherapy in Locally Advanced and Metastatic Urothelial Carcinoma
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Gopa Iyer, MD
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| Sam Chang is joined in conversation by Gopa Iyer, discussing an article in European Urology that examines the predictive nature of FGFR3 wild-type versus mutant-type and its impact on patient response to perioperative chemotherapy in urothelial carcinoma.
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Exploring Erdafitinib: A Breakthrough in Non-Muscle Invasive Bladder Cancer Treatment
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Siamak Daneshmand, MD
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| Siamak Daneshmand shares insights from a phase 2 Study of the "Efficacy and Safety of Erdafitinib in Patients with Bacillus Calmette-Guérin-Unresponsive, High-Risk Non–muscle Invasive Bladder Cancer with FGFR3/2 Alterations" in THOR-2.
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Biological Pathways in Urothelial Carcinoma
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Carissa Chu, MD
Carissa Chu joins Sam Chang to discuss data on genetic changes and alterations in urothelial carcinoma. The purpose of the study is to characterize human epidermal growth factor receptor 2 and fibroblast growth factor receptor 3 mutations in a prospectively collected cohort of urothelial cancers.
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| Fibroblast Growth Factor Receptor 3 (FGFR3) Specificity, Promise of Efficacy with Less Toxicity for Patients with Urothelial Carcinomas?
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| Evan Yu, MD
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| Evan Yu discusses the results of the randomized phase 3 THOR trial, focusing on patients with specific FGFR2 or 3 mutations/fusions. This trial compared erdafitinib to taxane chemotherapy and revealed that patients receiving erdafitinib had a statistically significant overall survival benefit, with a median of 12.1 months compared to 7.8 months with chemotherapy. The data supports the role of erdafitinib in the post-PD-(L)-1 antibody-treated population and raises questions about potential confirmatory labels and broader applications.
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| THOR Phase 3: Results of Erdafitinib vs Pembrolizumab in Pretreated Patients With Advanced or Metastatic Urothelial Cancer With Select Fibroblast Growth Factor Receptor Alterations
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| Arlene Siefker-Radtke, MD
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| Arlene Siefker-Radtke presents the results of the THOR study, a phase 3 trial comparing erdafitinib to pembrolizumab in pretreated patients with advanced or metastatic urothelial cancer with select FGFR alterations. The trial had two cohorts, and while cohort 1 showed that erdafitinib improved survival over chemotherapy in patients with FGFR-altered urothelial cancer, cohort 2 focused on comparing erdafitinib to pembrolizumab in anti-PD(L)1-naïve patients with FGFR alterations.
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| Added Value of ctDNA Testing For Identifying FGFR3 Alterations In Metastatic Urothelial Cancer Eligible For Erdafitinib Treatment
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| David Müller, MD
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| David Müller discusses the role of cell-free DNA evaluated in comparison to tissue testing for detecting FGFR alterations in patients with progressing metastatic urothelial carcinoma eligible for FGFR inhibitor therapy, particularly erdafitinib. The study involved deep-targeted sequencing of cfDNA and matched leukocyte DNA and a quantitative (q)PCR assay was designed to assess the most common FGFR3 mutations in cfDNA.
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| FGFR3 Alterations in PROOF 302: A Phase III Trial of Infigratinib (BGJ398) as Adjuvant Therapy in Patients with Invasive Urothelial Carcinoma
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| Petros Grivas, MD, Ph.D.
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| Petros Grivas presents data from the PROOF 302 phase III trial, which focused on adjuvant therapy for patients with high-risk invasive urothelial carcinoma who had FGFR3 alterations. The trial enrolled patients with high-risk invasive upper tract urothelial carcinoma or urothelial carcinoma of the bladder with FGFR3 alterations. The prevalence of FGFR3 alterations was found to be 19% among all patients screened for the trial.
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| Discussant: THOR – Results of Erdafitinib versus Chemotherapy in Patients with Advanced or Metastatic Urothelial Cancer with Select Fibroblast Growth Factor Receptor Alterations
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| Daniel Petrylak, MD
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| Daniel Petrylak discusses the findings of the THOR study, a phase 3 trial comparing erdafitinib to chemotherapy in patients with advanced or metastatic urothelial cancer with select FGFR alterations. He emphasizes the importance of FGFR testing in all metastatic urothelial carcinoma patients and highlighted the superior efficacy of erdafitinib compared to chemotherapy in patients with FGFR3/2 alterations.
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