What FGFR inhibitor would you use for a patient with cholangiocarcinoma and a FGFR3 mutation?

Honestly, the response to these inhibitors with FGFR alterations beyond FGFR2 fusions is quite low in the data known to date. The initial infigratinib study had responses primarily in the fusions. Similar outcomes were seen in the first study with pemigatinib (Abou-Alfa et al., PMID 32203698). There are a few ongoing studies with other FGFR alterations that the patient would be eligible for - the Debio compound and infigratinib both have studies open to other alterations, so you could look for eligibility for those. Would also make sure NGS was comprehensive to see if any other more actionable alterations noted.