A multidisciplinary European expert panel developed practical, step-by-step recommendations for FGFR3 testing in locally advanced (LA) or metastatic urothelial carcinoma (mUC), covering sample acquisition, testing methods (PCR and NGS), liquid biopsy, and molecular result reporting.
The panel recommends FGFR3 testing at diagnosis for all LA/mUC patients using validated qPCR or NGS assays; liquid biopsy (ctDNA via PCR/NGS) may complement tissue testing but requires further validation. Reports should classify alterations using ESMO-SCALE actionability tiers.
Narrative review based on expert opinion and clinical experience rather than primary data; liquid biopsy evidence for FGFR3 detection in mUC remains immature; recommendations reflect a European panel and may not generalize globally.
Test all LA/mUC patients for FGFR3 alterations at diagnosis using validated qPCR or NGS to enable timely access to erdafitinib. Multidisciplinary teams—pathologists, molecular biologists, oncologists, and urologists—should coordinate testing and reporting to support personalized treatment decisions.
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