Gastric Cancer — SCE Medical Oncology MCQ
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Correct answer: C — Futibatinib irreversibly inhibits FGFR1-4; pemigatinib reversibly inhibits FGFR1-3
NICE TA1005 recommends futibatinib after at least one prior systemic line and explicitly describes it as an alternative to pemigatinib, so access does not uniquely select either drug. Futibatinib covalently and irreversibly inhibits FGFR1-4, whereas pemigatinib is a reversible selective FGFR1-3 inhibitor. Futibatinib reversibly inhibits FGFR1-3; pemigatinib covalently inhibits FGFR1-4: this reverses both drugs’ binding behaviour and target breadth. Futibatinib irreversibly inhibits FGFR2 alone; pemigatinib reversibly inhibits FGFR1-4: futibatinib is not FGFR2-only and pemigatinib is not an FGFR4 inhibitor. Futibatinib irreversibly inhibits VEGFR1-3; pemigatinib reversibly inhibits FGFR1-3: futibatinib is a pan-FGFR rather than VEGFR inhibitor. Futibatinib reversibly inhibits FGFR1-4; pemigatinib irreversibly inhibits FGFR1-3: the target ranges are retained but the reversible and irreversible properties are swapped.
Reference: NICE TA1005 futibatinib for previously treated advanced cholangiocarcinoma with FGFR2 fusion or rearrangement (Published September 2024; current NICE TA): https://www.nice.org.uk/guidance/ta1005/chapter/1-Recommendation; Lytgobi 4 mg UK summary of product characteristics (Current UK SmPC, accessed July 2026): https://www.medicines.org.uk/emc/product/100700/smpc; Preclinical characterisation of pemigatinib as a reversible selective FGFR1-3 inhibitor (Published June 2020): https://pmc.ncbi.nlm.nih.gov/articles/PMC7313537/