Infigratinib
Infigratinib is an kinase inhibitor in development for the treatment of achondroplasia and hypochondroplasia.[1][4][5] Infigratinib targets the fibroblast growth factor receptors FGFR1, FGFR2, and FGFR3.[4][6] Infigratinib was originally approved at a higher dose for medical use in the United States in May 2021 for cholangiocarcinoma, but is no longer marketed for that indication due to difficulties commercializing in the indication.[4][7][8][9][10][11] Medical usesInfigratinib is currently in clinical trials for the treatment of children with achondroplasia. Infigratinib is now in a Phase 3 clinical trial.[12] Infigratinib was originally developed at a higher dose for the treatment of adults with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma (bile duct cancer) with a fibroblast growth factor receptor 2 (FGFR2) fusion or other rearrangement as detected by an FDA-approved test.[4][7] HistoryThe US Food and Drug Administration (FDA) approved infigratinib based on evidence from one clinical trial (NCT02150967) of 108 participants with bile duct cancer (cholangiocarcinoma).[7] The CBGJ398X2204 trial was a multicenter open-label single-arm trial that enrolled 108 participants with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with an FGFR2 fusion or rearrangement as determined by local or central testing.[8] The trials were conducted at 18 sites in the United States, Europe, and Asia.[7] The trial enrolled adult participants with bile duct cancer who had been treated previously with chemotherapy for their advanced cancer and whose tumors had a certain type of abnormality in the FGFR2 gene.[7] Participants received infigratinib once daily by mouth for 21 consecutive days followed by 7 days off therapy.[7] This 28-day cycle was administered until disease progression or the side effects became too toxic.[7] The trial measured the percentage of participants who achieved partial or complete shrinkage of their cancer and how long that shrinkage lasted (duration of response or DoR).[7] Infigratinib has since been developed at a lower dose (0.25 mg/kg) for children with achondroplasia, a condition caused by variants in the FGFR3 gene. Preliminary Phase 2 results showed that children treated with infigratinib showed a mean change from baseline in annualized height velocity of +2.51 cm/yr at 12 months, with no serious adverse events. Society and cultureLegal statusInfigratinib was designated an orphan drug by the FDA[13] and the European Medicines Agency in 2021.[14] It was approved for medical use under the FDA's accelerated approval program in May 2021.[7][8] Infigratinib has since been withdrawn from commercialization due to the sponsor's difficulties distributing the drug and enrolling a confirmatory clinical trial.[11] References
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