Introduction
Liver cancer has become the second and sixth most common cause of
cancer-associated deaths in men and women (1). Hepatocellular carcinoma
(HCC) accounts for 75–85% of patients with liver cancer and is a major
health burden worldwide (2,3). Intrahepatic cholangiocarcinoma (ICC) is
a malignant neoplasm occurring in the epithelium of the biliary tract
and the second most common primary liver cancer following HCC,
accounting for approximately 15% of primary liver cancers and 3% of
gastrointestinal tumors (4,5). Since ICC is often asymptomatic in its
early stages and detected in advanced stages, curative therapy cannot be
identified in many patients with ICC. Chemotherapy is the primary
treatment for patients with advanced stage with the combination of
gemcitabine and cisplatin (GC therapy); the combination of gemcitabine
and S-1; and the triple combination of gemcitabine, cisplatin, and S-1
as the well-established first-line treatment options for unresectable
ICC (6–8). However, no effective second-line chemotherapy has been
established due to insufficient clinical benefits (9,10).
Recently, comprehensive genomic profiling (CGP) has been approved and
used in clinical practice. It can detect genetic alterations, may verify
alternative treatment options, and achieve personalized treatment by
inhibiting specific molecular drivers in critical signaling pathways
(11). Fibroblast growth factor
receptor 2 (FGFR2) fusion is found
in ICC and occurs in up to
approximately 10–20% of patients (4). Pemigatinib is an FGFR1-,
FGFR2-, and FGFR3-selective inhibitor and is currently approved for the
treatment of previously treated unresectable ICC with FGFR2 fusion (12).
However, reports on using pemigatinib for the treatment of ICC are
limited. Herein, we reported the case of a 53-year-old woman with stage
IVB ICC who was treated with pemigatinib. In this case, there are two
points worth mentioning: the liquid CGP was useful for detecting FGFR2
fusion and the patient experienced typical side effects of pemigatinib
that required treatment.