THOR

THOR, trial NCT03390504 sponsored by Johnson & Johnson and reported in 2023, produced the first targeted tablet to lengthen survival in bladder cancer, for the fifth of advanced urothelial tumours with FGFR alterations. Cohort 1 randomised 266 patients with FGFR3 or FGFR2 alterations after chemotherapy and a checkpoint inhibitor to erdafitinib or chemotherapy and met its primary overall survival endpoint with a clear benefit, while cohort 2, against pembrolizumab in immunotherapy-naive patients, showed no benefit, so erdafitinib is positioned after immunotherapy; full FDA approval followed in January 2024. OnCo links it to bladder cancer, FGFR2 as a target, erdafitinib and the FGFR3 alterations term, and THOR-2 explored intravesical and oral use in non-muscle-invasive disease. Whether FGFR inhibitors can be combined with immunotherapy rather than sequenced after it is the open question.