Targeted therapies are part of newer treatments called precision medicine. Targeted therapies only target cancer cells and are tailored to the exact kind of tumor you have.

Many older cancer treatments kill cancer cells, but also healthy cells. These treatments work very well but have side effects and are harder on your body.

Targeted therapies harm your cancer cells but keep your healthy cells and tissues safe.

Genetic testing and targeted therapies

Targeted therapies use information about your own genes and proteins to treat your cancer. Treatments must be matched to the genetic traits of your tumor. Genetic testing tells us if you should have targeted therapy. It also tells us which targeted drugs will work best for you. It’s very important to have accurate genetic tests to get information about your tumor.

For advanced bladder cancer that has spread, we use a test only offered at MSK called MSK-IMPACT®. It looks at about 500 genes for genetic changes (mutations or variants) and other tumor traits. By learning as much as possible about your mutations, we can find a treatment that targets your cancer.

For example, an alteration (change) in a protein called FGFR can make cancer cells grow more quickly and spread. We recommend MSK-IMPACT testing for most of our patients who have metastatic bladder cancer.

If MSK-IMPACT shows you have an FGFR2 or FGFR3 alteration, you may be able to get treatment with the targeted drug erdafitinib (Balversa™). This drug blocks FGFR, which can slow or stop the growth of your cancer cells.

You also may be able to join a clinical trial that is studying erdafitinib, or others testing new FGFR inhibitors.   MSK is researching erdafitinib to treat non-muscle invasive bladder cancer (NMIBC) that has come back after treatment.

Our researchers are looking at whether erdafitinib can help people with a mutation in the FGFR3 gene. Changes in FGFR3 are common in NMIBC that has come back after standard treatments, such as bacillus Calmette-Guerin (BCG) or chemotherapy.