pemigatinib at a glance
Medicine class
FGFR1, FGFR2 and FGFR3 tyrosine kinase inhibitor
Usual use
Previously treated, locally advanced or metastatic cholangiocarcinoma with an FGFR2 fusion or rearrangement
Before treatment
The tumour's FGFR2 status must be confirmed using an appropriate diagnostic test
Administration
Swallow the tablet whole, with or without food
Important monitoring
Blood phosphate and eye health require regular assessment
What is pemigatinib used for?
UK-licensed use:
Pemigatinib alone may treat adults with locally advanced or metastatic cholangiocarcinoma that has an FGFR2 fusion or rearrangement and has progressed after at least one previous systemic treatment.
How does pemigatinib work?
FGFR2 fusions or rearrangements can produce abnormal growth signals in some bile duct cancers. Pemigatinib inhibits FGFR1, FGFR2 and FGFR3 signalling, reducing the survival and growth of cells driven by these alterations. FGFR inhibition also explains effects such as increased blood phosphate.
pemigatinib preparations and strengths
Tablet
Route: Oral
Strengths: 4.5 mg, 9 mg, 13.5 mg
How to take pemigatinib
Follow the treatment calendar supplied by the oncology team.
Swallow tablets whole; do not crush, chew, split or dissolve them.
Take with or without food.
Avoid grapefruit and grapefruit juice.
Do not change or stop treatment without speaking to the oncology team.
pemigatinib side effects
Common or expected effects
- Increased or decreased blood phosphate
- Hair loss and nail changes
- Diarrhoea, constipation or nausea
- Sore mouth, dry mouth or altered taste
- Fatigue
- Dry eyes or blurred vision
- Dry skin or painful redness of the palms and soles
- Joint pain
- Increased blood creatinine
Get urgent medical advice
- New blurred vision, flashes or floaters, which may indicate retinal changes
- Severe confusion, seizures, weakness, breathing difficulty or abnormal heartbeat associated with phosphate disturbance
- Markedly reduced blood sodium
- Serious retinal or optic-nerve disorders
pemigatinib in pregnancy
Human pregnancy data are unavailable, and animal findings plus the medicine's mechanism indicate potential fetal harm. Pregnancy should be excluded before treatment. People who could become pregnant, and men with partners who could become pregnant, need effective contraception and an additional barrier method during treatment and for the period specified by the specialist after treatment.
pemigatinib while breastfeeding
It is unknown whether pemigatinib enters human milk, and risk to a breastfed child cannot be excluded. Breastfeeding should be stopped during treatment and for the period specified in the product information after treatment; discuss feeding plans with the oncology and maternity teams.
pemigatinib interactions
The oncology team and pharmacist should review prescribed, over-the-counter and herbal products before treatment.
St John's wort
Use is contraindicated because enzyme induction may substantially reduce pemigatinib exposure and effectiveness.
Strong CYP3A4 inhibitors, including itraconazole, ketoconazole and ritonavir
These can increase pemigatinib exposure and adverse effects, so concurrent use should generally be avoided.
Strong or moderate CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin and phenobarbital
These can reduce pemigatinib exposure and potentially reduce effectiveness.
Common questions about pemigatinib
Answers are fully visible for fast scanning and source review.
Why is genetic testing needed before pemigatinib?
Pemigatinib's licensed role requires an FGFR2 fusion or rearrangement in the tumour, so this must be confirmed with an appropriate diagnostic test.
Can pemigatinib be taken with food?
Yes. The tablets may be taken with or without food.
Can pemigatinib tablets be crushed or split?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.