Pemigatinib-induced nail changes - A case report

Pemigatinib is an FGFR inhibitor that is one of few second-line treatment options for cholangiocarcinoma. Nail toxicities were common in the phase 2 study evaluating the safety and efficacy of pemigatinib.

We describe a 54-year-old female with a history of stage IV cholangiocarcinoma presenting for a follow-up visit after completing Cycle 4 of pemigatinib. The patient had been having significant nail changes to her fingernails and toenails, which has led to her great toenails falling off.Management and outcome: The patient was prescribed betamethasone dipropionate 0.05% cream to help with her nail changes and instructed to continue vinegar and hot water soaks that she had already been doing. It was discussed that if this did not help with her nail changes, treatment may have to be held for 2 weeks to allow her nails to heal.

Nail changes are a common side effect with pemigatinib and should be monitored closely for the need for temporary disruption in therapy.