Pan-tumor landscape of fibroblast growth factor receptor 1-4 genomic alterations

K Murugesan, A Necchi, T C Burn, O Gjoerup, R Greenstein, M Krook, J A López, M Montesion, H Nimeiri, A R Parikh, S Roychowdhury, S Schwemmers, I M Silverman, A Vogel

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


BACKGROUND: Selective tyrosine kinase inhibitors targeting fibroblast growth factor receptor (FGFR) 1-4 genomic alterations are in development or have been approved for FGFR-altered cancers (e.g. bladder cancer and advanced intrahepatic cholangiocarcinoma). Understanding FGFR inhibitor-resistance mechanisms is increasingly relevant; we surveyed the pan-tumor landscape of FGFR1-4 genomic alterations [short variants (SVs), gene rearrangements (REs), and copy number alterations (CNAs)], including their association with tumor mutational burden (TMB) and the genomic comutational landscape.

PATIENTS AND METHODS: Comprehensive genomic profiling of 355 813 solid tumor clinical cases was performed using the FoundationOne and FoundationOne CDx assays (Foundation Medicine, Inc.) to identify genomic alterations in >300 cancer-associated genes and TMB (determined on ≤1.1 megabases of sequenced DNA).

RESULTS: FGFR1-4 SVs and REs occurred in 9603/355 813 (2.7%), and CNAs in 15 078/355 813 (4.2%) samples. Most common FGFR alterations for bladder cancer, intrahepatic cholangiocarcinoma, and glioma were FGFR3 SVs (1051/7739, 13.6%), FGFR2 REs (618/6641, 9.3%), and FGFR1 SVs (239/11 550, 2.1%), respectively. We found several, potentially clinically relevant, tumor-specific associations between FGFR1-4 genomic alterations and other genomic markers. FGFR3 SV-altered bladder cancers and FGFR1 SV-altered gliomas were significantly less likely to be TMB-high versus unaltered samples. FGFR3 SVs in bladder cancer significantly co-occurred with TERT and CDKN2A/B alterations; TP53 and RB1 alterations were mutually exclusive. In intrahepatic cholangiocarcinoma, FGFR2 REs significantly co-occurred with BAP1 alterations, whereas KRAS, TP53, IDH1, and ARID1A alterations were mutually exclusive. FGFR1 SVs in gliomas significantly co-occurred with H3-3A and PTPN11 alterations, but were mutually exclusive with TERT, EGFR, TP53, and CDKN2A/B alterations.

CONCLUSIONS: Overall, our hypothesis-generating findings may help to stratify patients in clinical trials and guide optimal targeted therapy in those with FGFR alterations.

Original languageEnglish (US)
Pages (from-to)100641
JournalESMO Open
Issue number6
StatePublished - Dec 2022


  • Humans
  • Bile Duct Neoplasms
  • Bile Ducts, Intrahepatic
  • Biomarkers, Tumor/genetics
  • Cholangiocarcinoma/genetics
  • Genomics
  • Glioma/genetics
  • Receptor, Fibroblast Growth Factor, Type 1/genetics
  • Urinary Bladder Neoplasms/drug therapy
  • Receptor Protein-Tyrosine Kinases/metabolism


Dive into the research topics of 'Pan-tumor landscape of fibroblast growth factor receptor 1-4 genomic alterations'. Together they form a unique fingerprint.

Cite this