Hyperphosphatemic Tumoral Calcinosis With Pemigatinib Use

Pemigatinib, a fibroblast growth factor receptor (FGFR) 1-3 inhibitor, is a novel therapeutic approach for treating cholangiocarcinoma when an FGFR fusion or gene rearrangement is identified. Although the most reported side effect of pemigatinib is hyperphosphatemia, tumoral calcinosis with soft tis...

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Bibliographic Details
Published in:AACE clinical case reports 2022-09, Vol.8 (5), p.217-220
Main Authors: Puar, Akshan, Donegan, Diane, Helft, Paul, Kuhar, Matthew, Webster, Jonathan, Rao, Megana, Econs, Michael
Format: Article
Language:English
Subjects:
calcification
fibroblast growth factor 23
fibroblast growth factor receptor
hyperphosphatemia
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Summary:Pemigatinib, a fibroblast growth factor receptor (FGFR) 1-3 inhibitor, is a novel therapeutic approach for treating cholangiocarcinoma when an FGFR fusion or gene rearrangement is identified. Although the most reported side effect of pemigatinib is hyperphosphatemia, tumoral calcinosis with soft tissue calcifications is not widely recognized as a complication. We report a case of patient with hyperphosphatemic tumoral calcinosis on pemigatinib. A 59-year-old woman with progressive metastatic cholangiocarcinoma, despite receiving treatment with cisplatin and gemcitabine for 7 months, was found to have an FGFR2-BICC1 fusion in the tumor on next-generation sequencing. Pemigatinib was, therefore, initiated. Four months into the therapy, multiple subcutaneous nodules developed over the lower portion of her back, hips, and legs. Punch biopsies revealed deep dermal and subcutaneous calcifications. Investigations revealed elevated serum phosphorus (7.5 mg/dL), normal serum calcium (8.7 mg/dL), and elevated intact fibroblast growth factor-23 (FGF23, 1216 pg/mL; normal value
ISSN:2376-0605
2376-0605
DOI:10.1016/j.aace.2022.07.001