First-in-Human Phase I Study of Fisogatinib (BLU-554) Validates Aberrant FGF19 Signaling as a Driver Event in Hepatocellular Carcinoma.

Kim, Richard D; Sarker, Debashis; Meyer, Tim; Yau, Thomas; Macarulla, Teresa; Park, Joong-Won; Choo, Su Pin; Hollebecque, Antoine; Sung, Max W; Lim, Ho-Yeong; Mazzaferro, Vincenzo; Trojan, Joerg; Zhu, Andrew X; Yoon, Jung-Hwan; Sharma, Sunil; Lin, Zhong-Zhe; Chan, Stephen L; Faivre, Sandrine; Feun, Lynn G; Yen, Chia-Jui; ... (2019). First-in-Human Phase I Study of Fisogatinib (BLU-554) Validates Aberrant FGF19 Signaling as a Driver Event in Hepatocellular Carcinoma. Cancer discovery, 9(12), pp. 1696-1707. American Association for Cancer Research 10.1158/2159-8290.CD-19-0555

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Outcomes for patients with advanced hepatocellular carcinoma (HCC) remain poor despite recent progress in drug development. Emerging data implicate FGF19 as a potential HCC driver, suggesting its receptor, FGFR4, as a novel therapeutic target. We evaluated fisogatinib (BLU-554), a highly potent and selective oral FGFR4 inhibitor, in a phase I dose-escalation/dose-expansion study in advanced HCC using FGF19 expression measured by IHC as a biomarker for pathway activation. For dose escalation, 25 patients received 140 to 900 mg fisogatinib once daily; the maximum tolerated dose (600 mg once daily) was expanded in 81 patients. Fisogatinib was well tolerated; most adverse events were manageable, grade 1/2 gastrointestinal events, primarily diarrhea, nausea, and vomiting. Across doses, the overall response rate was 17% in FGF19-positive patients [median duration of response: 5.3 months (95% CI, 3.7-not reached)] and 0% in FGF19-negative patients. These results validate FGFR4 as a targetable driver in FGF19-positive advanced HCC. SIGNIFICANCE: Fisogatinib elicited clinical responses in patients with tumor FGF19 overexpression in advanced HCC. These results validate the oncogenic driver role of the FGFR4 pathway in HCC and the use of FGF19 as a biomarker for patient selection.See related commentary by Subbiah and Pal, p. 1646.This article is highlighted in the In This Issue feature, p. 1631.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Dufour, Jean-François

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2159-8290

Publisher:

American Association for Cancer Research

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

14 Jan 2020 08:14

Last Modified:

14 Jan 2020 08:14

Publisher DOI:

10.1158/2159-8290.CD-19-0555

PubMed ID:

31575541

BORIS DOI:

10.7892/boris.137070

URI:

https://boris.unibe.ch/id/eprint/137070

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