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Pemigatinib + afatinib is a combination of two oral small molecule tyrosine kinase inhibitors used in investigational studies to treat advanced solid tumors with FGFR alterations, including cholangiocarcinoma. Pemigatinib is a selective inhibitor of fibroblast growth factor receptor (FGFR) 1–3, blocking aberrant FGFR signaling that drives tumor growth. Afatinib is an irreversible inhibitor of the epidermal growth factor receptor (EGFR) family, targeting EGFR/HER2/HER4, and is used to block EGFR-mediated cell proliferation. The rationale for this combination is to overcome treatment resistance by inhibiting both FGFR and EGFR signaling pathways, which may act as bypass tracks for tumor growth in resistant cancers. Preclinical and early phase clinical studies show this drug pairing can cause significant tumor regression in models resistant to single-agent FGFR inhibitors and is under investigation in clinical trials for patients with FGFR-altered advanced solid tumors, including cholangiocarcinoma[1][5].
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