Prolonged Clinical Benefit with Futibatinib in a Patient with FGFR Inhibitor–Pretreated FGFR2 Fusion–Positive Intrahepatic Cholangiocarcinoma: Case Report

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Multiple FGFR inhibitors have demonstrated significant activity in pretreated advanced FGFR2 fusion–positive intrahepatic cholangiocarcinoma. The irreversible pan-FGFR inhibitor futibatinib has the potential to overcome acquired resistance to ATP-competitive FGFR inhibitors in a subset of patients. We present a case of prolonged clinical benefit using FGFR inhibitors sequentially, initially an ATP-competitive inhibitor followed by futibatinib upon progression, for a total of 36 months of FGFR-targeting therapy. This case supports sequential FGFR-targeting therapies for FGFR2 fusion–positive cholangiocarcinoma, with futibatinib acting as rescue therapy after failure of ATP-competitive inhibitors.