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# FGFR inhibitors

Oral kinase inhibitors for tumours driven by FGFR changes, such as bladder cancer and cholangiocarcinoma. High phosphate and eye effects.

Updated Nov 12, 2026

## What they are

Erdafitinib treats urothelial carcinoma with FGFR3 alterations; pemigatinib treats cholangiocarcinoma with FGFR2 fusions and myeloid or lymphoid neoplasms with FGFR1 rearrangement. A genomic test is required before treatment.

## Mechanism of action

Fibroblast growth factor receptors (FGFR1–4) are receptor tyrosine kinases. Mutations, amplifications or gene fusions can keep them permanently active and drive tumour growth. These drugs occupy the ATP site and block signalling. Inhibiting FGFR also raises blood phosphate in most patients, an on-target effect.

Target: Fibroblast growth factor receptor tyrosine kinases (FGFR1–4)

## Key points

- A test for the FGFR alteration is required: FGFR3 in urothelial cancer, FGFR2 fusions in cholangiocarcinoma.
- Hyperphosphataemia is expected; phosphate is measured and diet adjusted.
- Eye toxicity: dry eyes and serous retinal detachment; regular eye exams.
- Skin, nail and mouth toxicity (stomatitis, onycholysis, hand-foot reactions).

## Drugs in this class

- [**Erdafitinib** An oral pan-FGFR inhibitor for urothelial cancer with FGFR3 changes. Raises blood phosphate and harms the eyes, skin… Fibroblast growth factor receptor kinases (FGFR1–4)](https://durgical.com/en/pharmacology/erdafitinib/)
- [**Pemigatinib** An oral FGFR1–3 inhibitor for cholangiocarcinoma with FGFR2 fusions and for rare FGFR1-rearranged blood cancers. High… Fibroblast growth factor receptor kinases (FGFR1–3)](https://durgical.com/en/pharmacology/pemigatinib/)

## Others in the class

- Infigratinib

## Test yourself

Think of the answer, then tap the question to see it.

## Is the high blood phosphate on FGFR inhibitors an off-target effect?

No: it is an on-target consequence of FGFR inhibition, so phosphate is measured and the diet adjusted.

## Which FGFR alteration is targeted in cholangiocarcinoma?

FGFR2 fusions or rearrangements.

## Which examination is repeated on FGFR inhibitors?

Eye examination of the retina.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01EN) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [Erdafitinib: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a619031.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Pemigatinib: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a620028.html) (MedlinePlus (U.S. National Library of Medicine), 2026).

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