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As researchers have learned more about the changes inside cells that cause them to become cancer cells, they have developed newer drugs that target some of these changes. These targeted drugs work differently from other types of treatment, such as chemotherapy (chemo). They may work in some cases when other treatments don't. Targeted drugs also often have different types of side effects.

FGFR inhibitor

Fibroblast growth factor receptors (FGFRs) are a group of proteins on bladder cancer cells that can help them grow. In some bladder cancers, the cells have changes in FGFR genes, which are the genes that control how much of the FGFR proteins are made. Drugs that target cells with FGFR gene changes (called FGFR inhibitors) can help treat some people with bladder cancer.

Erdafitinib (Balversa)

This FGFR inhibitor can be used to treat advanced bladder cancer that has certain changes detected in the FGFR3 gene, and that is still growing despite treatment with other drugs, such as chemo. This drug isn’t usually given to people who are eligible for but haven’t yet received an immune checkpoint inhibitor.

Erdafitinib is taken by mouth as tablets, typically once a day.

Common side effects of erdafitinib include mouth sores, feeling tired, changes in kidney or liver function, diarrhea, dry mouth, changes in fingernails or toenails, changes in mineral levels in the blood (such as phosphate and sodium), loss of appetite, changes in how things taste, low red blood cell counts (anemia), dry skin, dry eyes, and hair loss.

Other side effects can include hand-foot syndrome (redness, swelling, peeling or tenderness on the hands or feet), constipation, belly pain, nausea, and muscle pain.

This drug can also cause eye problems, which can sometimes be serious, so people taking this drug need to have regular eye exams and should tell their health care provider right away if they have blurred vision, loss of vision, or other visual changes.

Antibody-drug conjugates

Antibody-drug conjugates (ADCs) might also be considered a form of targeted therapy. These medicines are made up of a chemo drug linked to a monoclonal antibody, which is a lab-made version of an immune system protein that’s designed to attach to a specific target on cancer cells. Once inside the body, the antibody part of the ADC acts like a homing device, bringing the chemo directly to the cancer cells.

ADCs that can be used to treat bladder cancer include Enfortumab vedotin (Padcev).

For more on these drugs, see Immunotherapy for Bladder Cancer.