Targeting the Fibroblast Growth Factor Receptor (FGFR) Family in Lung Cancer

• Published in: Cells (Basel, Switzerland) Vol. 10; no. 5; p. 1154
• Main Authors: Pacini, Laura, Jenks, Andrew D, Lima, Nadia Carvalho, Huang, Paul H
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10-05-2021; MDPI
• Subjects: Amino acids; Antibodies, Monoclonal; Antineoplastic Agents - pharmacology; Biomarkers, Tumor - metabolism; Cell division; Cell Survival; Chromosomes; Clinical trials; Clinical Trials as Topic; drug resistance; Drug Resistance, Neoplasm; Epidermal growth factor; Epidermal growth factor receptors; ErbB Receptors - metabolism; FGFR; Fibroblast growth factor receptors; Fibroblasts; Gene Expression Regulation, Neoplastic; Genes, ras; Growth factors; Humans; Kinases; Ligands; Lung cancer; Lung Neoplasms - metabolism; Mutants; Mutation; Non-small cell lung carcinoma; Patients; Point Mutation; Protein-tyrosine kinase; Proteins; Receptor, Fibroblast Growth Factor, Type 1 - metabolism; Review; Sarcoma; Signal transduction; Small cell lung carcinoma; Translocation; Translocation, Genetic; Tumors; tyrosine kinase inhibitors; lung cancer; tyrosine kinase inhibitors; drug resistance; FGFR
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells10051154

Lung cancer is the most common cause of cancer-related deaths globally. Genetic alterations, such as amplifications, mutations and translocations in the fibroblast growth factor receptor (FGFR) family have been found in non-small cell lung cancer (NSCLC) where they have a role in cancer initiation and progression.
aberrations have also been identified as key compensatory bypass mechanisms of resistance to targeted therapy against mutant epidermal growth factor receptor (EGFR) and mutant Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) in lung cancer. Targeting FGFR is, therefore, of clinical relevance for this cancer type, and several selective and nonselective FGFR inhibitors have been developed in recent years. Despite promising preclinical data, clinical trials have largely shown low efficacy of these agents in lung cancer patients with
alterations. Preclinical studies have highlighted the emergence of multiple intrinsic and acquired resistance mechanisms to FGFR tyrosine kinase inhibitors, which include on-target
gatekeeper mutations and activation of bypass signalling pathways and alternative receptor tyrosine kinases. Here, we review the landscape of FGFR aberrations in lung cancer and the array of targeted therapies under clinical evaluation. We also discuss the current understanding of the mechanisms of resistance to FGFR-targeting compounds and therapeutic strategies to circumvent resistance. Finally, we highlight our perspectives on the development of new biomarkers for stratification and prediction of FGFR inhibitor response to enable personalisation of treatment in patients with lung cancer.