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Understanding MIBC biology for novel treatment options

Prof. Yohann Loriot (Université Paris-Saclay, France) discussed novel treatment options beyond immunotherapy [1]. He urged that a better understanding of the tumour biology is necessary to identify new targets and will facilitate precision medicine.

Approaches derived from fundamental tumour biology have demonstrated clinical efficacy, including fibroblast growth factor receptor (FGFR) inhibitors and antibody-drug conjugates. In muscle-invasive bladder cancer (MIBC), somatic genetic alterations are potentially targetable, including mutations in *FGFR3*, *HHRm*, HER2, components of angiogenesis, and the epigenome.

*FGFR3* mutation is associated with luminal-papillary urothelial carcinoma; 70% of this pathology harbours somatic activating mutations, 20% exhibits gene rearrangement, and 10% overexpresses *FGFR3*. Specific FGFR inhibitors tested in urothelial cancer include BGJ398, rogaratinib, and erdafitinib. In the



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