Introduction: Fibroblast growth-factor receptor (FGFR) inhibition is a promising 
strategy of treatment in urothelial cancer (UC). FGFR3 mutations or fusions 
(mut/fus) are common in luminal-1 UC subtype, which exhibits poor responses to 
immunotherapy. Erdafitinib is a potent and selective pan-FGFR tyrosine kinase 
inhibitor. Based on the results of the phase 2 BLC2001 trial (NCT02365597), in 
which erdafitinib showed an overall response rate of 40% in metastatic UC with 
FGFR3 mut/fus, it is the first approved targeted therapy in metastatic UC. Areas 
covered: This review covers the preclinical and clinical evidence for 
erdafitinib, summarizes the results of other FGFR inhibitors tested in UC and 
explores future perspectives of FGFR inhibition in UC. Expert opinion: In the 
era of precision medicine, erdafitinib approval marks a step forward in UC. 
Erdafitinib qualifies as a compelling comparator in the salvage therapy setting. 
Special attention must be paid to typical adverse class-effects of FGFR 
inhibitors. In the near future, in order to achieve an optimal selection of 
molecularly-altered tumors, it will be important to assess the performance of 
different diagnostic tools and to investigate the role of liquid biopsy. 
Combinations with immunotherapy represent a novel therapeutic opportunity being 
tested in ongoing trials.