FGFR Testing in Metastatic Urothelial Carcinoma-Who, When, and How to Test

André Mansinho1,2, José Carlos Machado3,4,5, Cátia Faustino6

  • 1START Lisbon, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, Portugal.

Cancers
|February 13, 2026
PubMed

Insights

Accurate FGFR3 testing is crucial for selecting patients with metastatic urothelial carcinoma (mUC) for targeted therapies like erdafitinib. Standardizing this molecular profiling ensures optimal treatment planning for improved outcomes in mUC.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Metastatic urothelial carcinoma (mUC) presents limited treatment options.
  • Genomic research has identified actionable molecular targets in mUC.
  • Fibroblast growth factor receptor 3 (FGFR3) alterations are key drivers in bladder cancer.

Purpose of the Study:

  • To review key considerations for FGFR3 testing in mUC.
  • To discuss the routine incorporation of FGFR3 testing into clinical practice.
  • To highlight the importance of molecular profiling for guiding FGFR inhibitor therapy.

Main Methods:

  • Review of genomic and transcriptomic research in mUC.
  • Analysis of clinical trial data, including the THOR trial.
  • Discussion of molecular profiling techniques and standardization.

Main Results:

  • FGFR3 alterations are predictive biomarkers for FGFR inhibitor response.
  • Erdafitinib demonstrated clinical benefit in previously treated mUC patients with FGFR3 alterations.
  • Accurate and timely FGFR3 testing is essential for patient selection.

Conclusions:

  • FGFR3 testing is critical for optimizing treatment with FGFR inhibitors in mUC.
  • Standardization of FGFR3 testing is needed for clinical practice.
  • Molecular profiling advances have expanded therapeutic options for mUC.

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