To evaluate the oncologic prognostic value of
fibroblast growth factor receptor (FGFR) and to assess the safety and efficacy of its inhibitors in patients with urothelial bladder
carcinoma. A literature search using PubMed, Scopus, and Cochrane Library was conducted on June 2020 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The pooled recurrence-free survival (RFS), progression-free survival (PFS), and
cancer-specific survival (CSS) were calculated using a fixed or random effects model in patients with nonmuscle invasive
bladder cancer (
NMIBC). Overall, 62 studies comprising 9,229 patients were eligible and included in this systematic review and meta-analysis. Both FGFR3 mutation and
protein overexpression were significantly associated with RFS, PFS, CSS, and overall survival. FGFR3 mutation was associated with worse RFS and better PFS (pooled hazard ratio: 1.30; 95% confidence interval: 1.08-1.57, and pooled hazard ratio: 0.62; 95% confidence interval: 0.42-0.92, respectively) in patients with
NMIBC. In 11 studies reporting on the response to FGFR inhibitors, complete response rates, disease control rates, and overall response rate of 0% to 8%, 59.3% to 64.2%, and 40% were reported for
dovitinib,
infigratinib, and
erdafitinib, respectively. Based on this study, FGFR3 mutation is a statistically significant prognostic factor for RFS in
NMIBC. FGFR inhibitors have measurable benefit in patients with advanced and metastatic urothelial
carcinoma. However, the results of ongoing RCTs and future well-designed studies are awaited to capture the differential biologic and clinical behavior of
tumors harboring FGFR while helping to identify those who are most likely to benefit from FGFR inhibitors.