The difference between erdafitinib/Bocco and icotinib

Erdafitinib(Erdafitinib) and icotinib (Infigratinib) are both targeted drugs targeting fibroblast growth factor receptor (FGFR) abnormalities and play an important role in the treatment of tumors related to FGFR gene mutations. However, there are certain differences in their mechanisms, indications, and clinical applications. Erdafitinib is a second-generation small molecule FGFR inhibitor. Its mechanism of action is to inhibit abnormal signaling by binding to the kinase active site of the FGFR family, thereby preventing the proliferation and migration of tumor cells. Erdafitinib can target different isoform mutations or fusion events of FGFR1-4, showing a broad targeting spectrum, which makes it particularly effective in advanced urothelial cancer (bladder cancer). It also provides a treatment option for myeloid or lymphoid tumors associated with FGFR1 rearrangements.

In contrast, Infigratinib (Infigratinib) mainly targets FGFR2 fusion or rearrangement, especially in cholangiocarcinoma. It reduces abnormal cell signaling and inhibits tumor growth and metastasis by highly selectively inhibiting FGFR2 kinase activity. Icotinib has a more focused targeting and is suitable for patients with locally advanced or metastatic cholangiocarcinoma who have received previous systemic therapy, especially those with positive FGFR2 fusion or rearrangement. This high selectivity gives icotinib predictable efficacy when targeting specific molecular abnormalities, while reducing its impact on other FGFR subtypes and reducing the risk of non-target side effects.

In terms of indications, erdafitinib and icotinib are different. Erdafitinib is approved for the treatment of advanced or metastatic urothelial cancer harboring FGFR mutations, as well as myeloid or lymphoid tumors with FGFR1 rearrangements, while icotinib is mainly used for the treatment of advanced cholangiocarcinoma with FGFR2 fusions or rearrangements. In clinical practice, this means that when doctors select drugs, they need to accurately match the patient's specific genotype and tumor type. The broad-spectrum FGFR inhibition of erdafitinib is suitable for multiple types of FGFR abnormalities, while icotinib is more focused on specific subtypes.

In addition, there are differences in dosing regimen and tolerability between the two. Erdafitinib is generally administered daily at a fixed dose periodically, while icotinib is usually administered daily continuously until disease progression or intolerable toxicity. Both require regular monitoring of hematological indicators and electrolyte levels, but due to its wider inhibitory range, erdafitinib may require more frequent safety monitoring to deal with potential side effects such as hyperphosphatemia and visual abnormalities. Because of its more focused targeting, icotinib has a relatively controllable side effect spectrum, but attention still needs to be paid to hyperphosphatemia and gastrointestinal adverse reactions.

In general, both erdafitinib and icotinibAn important representative of FGFR-targeted therapy, erdafitinib has a broad-spectrum inhibitory effect and can target multiple subtypes of FGFR1-4. Its indications cover urothelial cancer and FGFR1-rearranged hematological tumors, while icotinib targets FGFR2 fusion or rearrangement and is mainly used for cholangiocarcinoma. The decision on which drug to choose should be based on the patient's specific molecular characteristics, tumor type and tolerance to achieve precise targeted therapy and long-term disease management.

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