Indirect treatment comparison of futibatinib with chemotherapy and pemigatinib in cholangiocarcinoma with FGFR2 fusions/rearrangements.

Abstract

440 Background: Futibatinib, an irreversible FGFR1–4 inhibitor, is being investigated for the treatment of advanced intrahepatic cholangiocarcinoma (iCC) with FGFR2 fusions/rearrangements. We conducted an indirect treatment comparison to evaluate efficacy outcomes with futibatinib for advanced iCC patients from the FOENIX-CCA2 trial (NCT02052778) relative to published data for chemotherapy and FGFR inhibitors. Methods: A systematic literature review was conducted to identify clinical trials for FGFR inhibitors published 01/2015-02/2021, with additional targeted searches for chemotherapy data. A simulated treatment comparison was conducted using individual-level patient data from FOENIX-CCA2 and published aggregate data from comparator trials, applying regression models to adjust for between-trial differences in baseline characteristics. Population-adjusted Cox regression models were used for base case time-to-event outcomes (progression-free survival [PFS], overall survival [OS], duration of response [DOR]) and binomial-logistic regressions for binary outcomes (objective response rate [ORR]). Results: Two studies of FGFR inhibitors among previously treated patients with FGFR2 fusions/rearrangements were identified with sufficient data for analysis: FOENIX-CCA2 (n=103) and FIGHT-202 (n=107, pemigatinib). Two studies were identified for chemotherapy in this setting (an analysis of prior systemic therapy in the FIGHT-202 cohort [n=53] and a natural history study using a clinicogenomic database [n=71]). Comparisons of futibatinib with chemotherapy showed significantly lower risk of progression or death with futibatinib (table). Comparisons of futibatinib with pemigatinib showed similar outcomes between treatments (table), however, there was a numerical advantage for futibatinib in all efficacy parameters. Conclusions: Data suggest that futibatinib provides longer survival vs chemotherapy among previously treated advanced iCC patients with FGFR2 fusions/rearrangements. No statistically significant differences were observed in efficacy outcomes between futibatinib and pemigatinib, although numerical trends favored futibatinib. Molecular detail such as improved activity against co-mutated tumours and resistance mutations may explain such trends. [Table: see text]

Cholangiocarcinoma: Molecular Abnormalities and Cells of Origin

“…Thus, indirect treatment comparison of futibatinib with chemotherapy and pemigatinib in CCA patients with FGFR2 fusions/rearrangements suggests that futibitib provides longer survival versus chemotherapy; similar efficacy was observed for futibatinib compared with pemigatinib. 83 Meric-Bernstam et al 84 have reported the results of a phase I dose-expansion trial evaluating the response of advanced tumors with FGFR1-3 aberrations to futibatinib. The greatest anti-tumor activity was observed in FGFR2 fusion/rearrangement-positive iCCA, with 25.4% of the overall response rate.…”

Fibroblast growth factor receptors as targets for anticancer therapy in cholangiocarcinomas and urothelial carcinomas

“…A treatment comparison was performed using patient data from FIGHT-202 (n = 107, pemigatinib) and FOENIX-CCA2 (n = 103, futibatinib) and demonstrated a significantly lower risk of progression or death when patients were treated with futibatinib compared to chemotherapy [ 30 ]. No statistically-significant differences were found in treatment outcomes between futibatinib and pemigatinib; however, numerical benefits for futibatinib were observed.…”