Calcinosis cutis dermatologic toxicity associated with fibroblast growth factor receptor inhibitor for the treatment of Wilms tumor

J Cutan Pathol. 2018 Oct;45(10):786-790. doi: 10.1111/cup.13319. Epub 2018 Aug 3.


Small-molecule inhibitors (nibs) have revolutionized cancer therapy with the emergence of clinically efficacious treatment for advanced-stage malignancies. Fibroblast growth factor receptor (FGFR) inhibitors have shown therapeutic efficacy in malignancies with molecular-genetic alterations in the FGFR/fibroblast growth factor pathway. In a phase 1 clinical trial, erdafitinib, a pan FGFR inhibitor, was well tolerated with a manageable toxicity profile. Hyperphosphatemia was a frequent adverse event in patients treated with erdafitinib; however, no serious complications were observed with this therapy. Here, we report the development of calcinosis cutis dermatologic toxicity in a patient with hyperphosphatemia while treated with a novel selective FGFR inhibitor, INCB 54828-101. Awareness of this form of dermatologic toxicity from an FGFR inhibitor will be important for close monitoring of serum levels of phosphate, FGF23, vitamin D, and calcitriol, the management of adverse serum chemistry with chelators, and treatment decisions to either reduce dose or withhold FGFR inhibitor.

Keywords: FGFR inhibitor; calcinosis cutis; dermatologic toxicity.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Calcinosis / chemically induced*
  • Clinical Trials, Phase I as Topic
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology
  • Fibroblast Growth Factor-23
  • Humans
  • Kidney Neoplasms / drug therapy*
  • Male
  • Organic Chemicals / adverse effects*
  • Organic Chemicals / therapeutic use
  • Receptors, Fibroblast Growth Factor / antagonists & inhibitors
  • Skin Diseases / chemically induced*
  • Wilms Tumor / drug therapy*
  • Young Adult


  • Antineoplastic Agents
  • FGF23 protein, human
  • INCB 54828-101
  • Organic Chemicals
  • Receptors, Fibroblast Growth Factor
  • Fibroblast Growth Factor-23