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CASE REPORT
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 23-26

Ramucirumab and docetaxel in patients with metastatic urothelial carcinoma harboring fibroblast growth factor receptor alterations: A case series and literature review


1 Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
2 Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
3 Department of Radiology, Emory University, Atlanta, Georgia, USA

Correspondence Address:
Dr. Mehmet Asim Bilen
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, 1365 Clifton Road NE, B4301, Atlanta, GA 30322
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JIPO.JIPO_22_19

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Metastatic urothelial carcinoma (mUC) has a poor prognosis with a 5-year survival probability of 4.8%. The mainstay of first-line treatment is platinum-based chemotherapy. Second-line therapy involves immune checkpoint inhibitors or a fibroblast growth factor receptor (FGFR) inhibitor, erdafitinib, for patients harboring selected FGFR alterations. Several additional agents are under development for the treatment of mUC. Recent studies demonstrate that ramucirumab and docetaxel have clinical activity in mUC. We report two patients with metastatic upper tract urothelial cancer (mUTUC) with FGFR alterations who were heavily pretreated with FGFR inhibitors that later showed response to ramucirumab and docetaxel. Preclinical studies indicate that FGF and VEGF pathways work synergistically, which could explain the observations in our patients. Our findings may represent another treatment option for patients with mUC and FGFR alterations who have progressed on multiple lines of therapy.


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