Evidence map›Paper›PMID 41361008›Full record

ArticleNature genetics2026

Saturation mutagenesis identifies activating and resistance-inducing FGFR kinase domain mutations.

Carla Tangermann, Avantika Ghosh, Martin Ziegler, Francesco Facchinetti, Jannis Stappenbeck, Yagmur Oyku Carus Sahin, Marisa Riester, Luise Carmina Viardot, Tobias Zundel, Luc Friboulet and 10 more

Abstract read
In one paragraph

Article in Nature genetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Carla TangermannDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0000-0002-4715-4985
Avantika GhoshDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0009-0000-2172-3791
Martin ZieglerDivision of Personalized Medical Oncology (A420), German Cancer Research Center (DKFZ), Heidelberg, Germany and DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.ORCID 0000-0003-2137-5234
Francesco FacchinettiUniversité Paris-Saclay, Gustave Roussy, Inserm U981, Villejuif, France.
Jannis StappenbeckDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Yagmur Oyku Carus SahinDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0009-0008-3881-6140
Marisa RiesterDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0009-0006-4178-1685
Luise Carmina ViardotDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Tobias ZundelDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Luc FribouletUniversité Paris-Saclay, Gustave Roussy, Inserm U981, Villejuif, France.
Antoine HollebecqueDépartement d'Innovation Thérapeutique (DITEP), Gustave Roussy, Villejuif, France.
José J Naveja3rd Medical Department and University Cancer Center, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.ORCID 0000-0001-8640-6690
Angela WanningerDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Maria Elena HessInstitute of Medical Bioinformatics and Systems Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0009-0007-5792-3657
Tilman BrummerGerman Cancer Consortium (DKTK), partner site Freiburg, a partnership between DKFZ and University Medical Center Freiburg, Freiburg, Germany.ORCID 0000-0003-4387-7905
Melanie BoerriesGerman Cancer Consortium (DKTK), partner site Freiburg, a partnership between DKFZ and University Medical Center Freiburg, Freiburg, Germany.ORCID 0000-0002-3670-0602
Sonja LogesDivision of Personalized Medical Oncology (A420), German Cancer Research Center (DKFZ), Heidelberg, Germany and DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.
Yohann LoriotUniversité Paris-Saclay, Gustave Roussy, Inserm U981, Villejuif, France.ORCID 0000-0002-8338-1739
Anna L IllertGerman Cancer Consortium (DKTK), partner site Freiburg, a partnership between DKFZ and University Medical Center Freiburg, Freiburg, Germany.
Sven DiederichsDivision of Cancer Research, Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. s.diederichs@dkfz.de.ORCID 0000-0001-7901-4752

Funding

Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) PM4Onco FKZ 01ZZ2322ADeutsche Forschungsgemeinschaft (German Research Foundation) SFB 1453 - 431984000Deutsche Forschungsgemeinschaft (German Research Foundation) SFB 1479 441891347-S1
6 · The paper itself

Abstract

Variants of uncertain significance represent the biggest challenge for genomics-based precision oncology. Activated fibroblast growth factor receptors (FGFRs) frequently drive tumorigenesis by different genetic aberrations. However, it remains unknown which of the many point mutations affecting FGFR1, FGFR2, FGFR3 or FGFR4 in cancer are druggable, that is, activating signaling while not mediating FGFR inhibitor resistance. Here we implemented a saturation mutational scanning platform to screen all 11,520 possible point mutations covering the kinase domains of FGFR1-4. Pooled positive selection screens identified 474 activating and 738 mutations mediating resistance to the FGFR inhibitors pemigatinib and futibatinib, together revealing 301 druggable FGFR mutations analogous to a strong PS3/BS3 evidence level. The screens also identified loss-of-function mutations and an association of gain-of-function mutations with hydrophobic changes. The functional screens identified 97% of acquired resistance mutations in clinical trials. Our comprehensive catalog of every druggable mutation in the FGFR kinase domains is readily available for clinical decision support.

Indexed as

Drug Resistance, NeoplasmMutagenesisMutationReceptors, Fibroblast Growth FactorCell Line, TumorHumansMorpholinesNeoplasmsPoint MutationProtein DomainsProtein Kinase InhibitorsPyridazinesPyrimidinesPyrrolesReceptor, Fibroblast Growth Factor, Type 1Receptor, Fibroblast Growth Factor, Type 2FGFR1 protein, humanFGFR2 protein, humanMorpholinespemigatinibProtein Kinase InhibitorsPyridazinesPyrimidinesPyrrolesReceptor, Fibroblast Growth Factor, Type 1Receptor, Fibroblast Growth Factor, Type 2Receptor, Fibroblast Growth Factor, Type 4Receptors, Fibroblast Growth Factor

Identifiers

PMID41361008
PMCPMC12807871

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.