FGFR Alterations in Bladder Cancer-From Molecular Pathogenesis to Precision Oncology.

FGFR2/3 alterations are clinically actionable biomarkers across non-muscle-invasive, muscle-invasive, metastatic, and upper-tract urothelial carcinoma, supporting precision oncology strategies.

• Why it matters: FGFR pathway changes are common in urothelial carcinoma, but optimal use requires integrating molecular diagnostics with evolving targeted treatment approaches across disease stages.
• What they did: The review synthesizes evidence on FGFR3-predominant alterations and selected FGFR2 fusions, covering comprehensive genomic profiling, tissue and plasma circulating tumor DNA testing, urine assays, and molecular residual disease assessment.
• The result: Clinical studies support combination strategies, next-generation FGFR inhibitors, and earlier FGFR-directed therapy, while emerging tools like AI-assisted pathology and integrated multi-omic biomarkers may improve patient selection.

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