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Updated: Mar 6, 2026

Oncogenic Gene Fusion Detection Using Anchored Multiplex Polymerase Chain Reaction Followed by Next Generation Sequencing
Published on: July 5, 2019
FGFR rearrangements: oncogenic drivers and therapeutic targets
Julia Yemelyanenko1, Jos Jonkers1, Daniel Zingg2
1Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Oncode Institute, Utrecht, The Netherlands.
Abstract:
Genomic amplifications and hotspot mutations affecting fibroblast growth factor receptors (FGFRs) have long been recognized as oncogenic drivers across human cancers. However, recent studies have uncovered FGFR in-frame fusions and complex structural variants as an additional class of tumor driver alterations. Notably, the identification of FGFR2 exon 18 truncations and the demonstration of their potent oncogenic competence have refined our understanding of FGFR-driven tumorigenesis and have impacted clinical trial design for FGFR-targeted agents. This review explores the biological and clinical implications of FGFR rearrangements. It covers their mechanisms in driving cancer, their potential as biomarkers to predict treatment response, and the emerging challenges and opportunities for FGFR-targeted therapy. Ultimately, a deeper understanding of FGFR rearrangements is critical for advancing precision oncology and improving patient benefit.
Insights
Fibroblast growth factor receptor (FGFR) rearrangements, including fusions and truncations, are key drivers of cancer. Understanding these alterations is crucial for developing targeted therapies and advancing precision oncology.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Fibroblast growth factor receptors (FGFRs) are implicated in cancer through amplifications and mutations.
- Emerging research identifies FGFR in-frame fusions and structural variants as significant oncogenic drivers.
- FGFR2 exon 18 truncations represent a potent class of tumor driver alterations, influencing tumorigenesis.
Purpose of the Study:
- To review the biological and clinical significance of FGFR rearrangements in cancer.
- To explore the mechanisms by which FGFR alterations drive tumor development.
- To discuss the role of FGFR rearrangements as biomarkers and therapeutic targets.
Main Methods:
- Literature review of studies on FGFR rearrangements in human cancers.
- Analysis of biological mechanisms underlying FGFR-driven tumorigenesis.
- Evaluation of clinical implications, including treatment response and therapeutic strategies.
Main Results:
- FGFR rearrangements, beyond mutations and amplifications, constitute a critical class of oncogenic drivers.
- FGFR2 exon 18 truncations demonstrate potent oncogenic activity.
- FGFR alterations have implications for predicting treatment response to FGFR-targeted agents.
Conclusions:
- A comprehensive understanding of FGFR rearrangements is essential for advancing precision oncology.
- Targeted therapies for FGFR alterations offer new avenues for cancer treatment.
- Further research into FGFR rearrangements will improve patient outcomes and therapeutic strategies.
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