Erdafitinib (Bocco) official instructions include usage, dosage and medication precautions

Erdafitinib is an oral small molecule fibroblast growth factor receptor (FGFR) inhibitor, mainly used to treat patients with locally advanced or metastatic urothelial cancer who have been confirmed to have FGFR2 or FGFR3 gene mutations or fusions. According to the official instructions, standardized molecular testing must be performed before taking the drug, which is a necessary prerequisite for initiating treatment. This drug is not suitable for all patients with urothelial cancer, but is a typical precision targeted therapy drug whose efficacy is highly related to genetic status.

In terms of usage and dosage, the recommended initial dose in the instructions is 8 mg taken orally once a day at a fixed time every day, with food or on an empty stomach. Tablets should be swallowed whole and should not be broken, chewed or crushed to avoid affecting drug release and absorption. Serum phosphorus levels are usually measured around the 14th day after treatment is initiated, which is a key node in erdafitinib dose management. If serum phosphorus levels do not reach the target range and are well tolerated by the patient, physicians may consider increasing the dose to 9 mg per day to enhance efficacy.

In terms of dose adjustment and treatment course management, erdafitinib adopts a continuous dosing strategy until disease progression or intolerable adverse reactions occur. If the patient experiences moderate to severe adverse reactions during treatment, such as obvious hyperphosphatemia, skin or mucosal toxicity, eye discomfort, etc., the drug should be temporarily discontinued or the dosage reduced according to the instructions, and treatment can be resumed after the symptoms are relieved. Some patients may need to maintain a lower dose for a long time, which does not mean a complete loss of efficacy, but is part of individualized medication management.

The official instructions particularly emphasize the importance of blood phosphorus monitoring. As erdafitinib inhibits the FGFR pathway and affects phosphate metabolism, hyperphosphatemia is one of its most common adverse reactions. Serum phosphorus levels need to be monitored frequently at the beginning of treatment, and the frequency of monitoring can be adjusted later based on stable conditions. Intervention with a low-phosphate diet, oral phosphate-lowering drugs, or dose adjustment can be used to reduce the risk of complications when necessary.

Ocular safety is another key point in the instructions for erdafitinib. This drug may cause central serous retinopathy, blurred vision, or visual distortion. Therefore, patients are recommended to undergo a baseline eye examination before taking the drug and to have regular reexaminations during treatment. Once symptoms such as vision loss and changes in visual field occur, medication should be suspended immediately and an ophthalmological evaluation should be conducted, and a decision on whether to continue treatment should be made after symptoms recover.

In addition, in terms of combined medication, the instructions indicate the need to be cautious when using potent CYP enzyme inhibitors or inducers. Such drugs may affect the plasma concentration of erdafitinib, thereby increasing toxicity or reducing efficacy. Patients with abnormal liver and kidney function also need to be fully evaluated before use and monitored during treatment. Overall, the official instructions for erdafitinib emphasize that genetic testing is the premise and dynamic monitoring is the core. Through standardized usage and dosage and strict medication precautions, the best therapeutic benefits can be achieved while ensuring safety.

Keyword tags: erdafitinib, usage and dosage, medication precautions, FGFR inhibitors, urothelial cancer, genetic testing, serum phosphorus monitoring, ophthalmological examination, dose adjustment, combined medication.

References:https://www.cancer.gov/publications/dictionaries/cancer-drug/def/erdafitinib