Would you prefer FGFR inhibitor or second line immunotherapy in a patient with metastatic urothelial cancer of the bladder with FGFR mutation?  

I would clearly prefer immunotherapy specifically with the use of pembrolizumab. I would measure the PDL1 CPS expression, where the impact is much greater. Phase 3 data clearly shows significantly improved survival compared to chemotherapy or BSC. This is the first positive trial in the second-line ...

Ideally clinical trial is the preferred option. There are many trials including THOR phase 3 trial comparing erdafitinib vs chemoTx and erdafitinib vs pembrolizumab. In the absence of trials, erdafitinib seems a very attractive 2nd line option for patients with FGFR activating mutation or fusion, es...