Is pemetinib (dalbertam) the last treatment option for advanced patients?

Pemigatinib is an oral FGFR2 (fibroblast growth factor receptor 2) inhibitor. It is mainly used to treat patients with advanced cholangiocarcinoma (cholangiocarcinoma) carrying FGFR2 gene fusion or rearrangement. In advanced cholangiocarcinoma, traditional chemotherapy regimens such as gemcitabine combined with cisplatin are often used as first-line treatment, but for patients who have failed multiple lines of treatment or cannot tolerate chemotherapy, treatment options are very limited. Pemetinib, as a drug targeting molecular targets, provides a new treatment method for this type of patients. Its mechanism is to block tumor cell proliferation and angiogenesis by inhibiting the FGFR2 signaling pathway, thereby delaying disease progression. Clinical studies have shown that pemetinib can induce partial tumor response or disease stabilization and prolong progression-free survival in some patients with advanced cholangiocarcinoma.

In the FIGHT-202 clinical trial, patients with advanced cholangiocarcinoma treated with pemetinib had an overall response rate of approximately 35% and a disease control rate exceeding < /span>80%, the median progression-free survival was 6.9 months, and the median overall survival was 21.1 months. Trial results show that for advanced patients who have failed chemotherapy, pemetinib can significantly improve disease control rate and quality of life, and provide the possibility of sustained remission for some patients. This makes pemetinib an important back-line or even multi-line option in the treatment of advanced FGFR2-positive cholangiocarcinoma, but not all patients are suitable for use, and its efficacy depends on genotyping and tumor characteristics.

It should be noted that pemetinib is not always the "last treatment option" for patients with advanced disease The prerequisite for its application is that the tumor has the molecular characteristics of FGFR2 fusion or rearrangement. In patients without such mutations, pemetinib may not be significantly effective. Therefore, in clinical practice, genetic testing must be performed before using pemetinib to clarify the FGFR2 status. In addition, the drug itself may cause adverse reactions such as hyperphosphatemia, hand-foot syndrome, and oral ulcers. Blood phosphorus levels, liver function, and skin conditions need to be monitored under the guidance of a doctor.

In general, pemetinib is an important targeted treatment option for patients with advanced cholangiocarcinomaFGFR2 positive. It is especially suitable for patients who have failed chemotherapy or cannot tolerate conventional chemotherapy, but it cannot be simply equated to the "last treatment option." It has significant efficacy and controllable safety, providing new hope for advanced patients and emphasizing the importance of personalized and precise treatment.

Reference materials:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967628/