Navigating FGFRi Therapy Adverse Effects: Nail Toxicities

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This is a video synopsis/summary of an OncLive Insights involving Lipika Goyal, MD; Chaundra Bishop; R. Katie Kelley, MD; and Caroline Kuhlman, NP.

Nail toxicity is a nearly universal adverse effect of FGFR inhibitors such as pemigatinib and futibatinib. Changes range from mild thickening and ridging to severe onycholysis (nail detachment) or complete nail loss, usually starting after 3 to 6 months on treatment. The fragmented, thickened nails can become painful, foul smelling, and embarrassing. Cracking around the nailbeds also risks bacterial or fungal infections such as paronychia. Patients should be warned to expect nail changes. To help mitigate issues, nails should be kept clean with vinegar soaks and antimicrobial ointments/solutions. Oral or topical antibiotics can treat infections. Dead nail material can be removed to prevent catching and discomfort. By 6 to 8 months after nail toxicity begins, most patients have complete nail loss, leaving only the matrix, which is often better tolerated than the fragmentation phase.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.