FGFR3

Chr 4ADAR

fibroblast growth factor receptor 3

Also known as: ACH, CD333, CEK2, HSFGFR3EX, JTK4

The protein functions as a fibroblast growth factor receptor with a cytoplasmic tyrosine kinase domain that binds acidic and basic fibroblast growth factors and regulates bone development and maintenance through downstream signaling cascades. Mutations cause multiple skeletal dysplasias including achondroplasia, hypochondroplasia, thanatophoric dysplasia types I and II, and craniosynostosis syndromes such as Muenke syndrome and Crouzon syndrome with acanthosis nigricans, inherited in autosomal dominant or autosomal recessive patterns. The pathogenic mechanism involves gain-of-function mutations that disrupt normal bone and cartilage development.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM, UniProt, Mechanism
GOFmechanismAD/ARLOEUF 0.6014 OMIM phenotypes
Clinical SummaryFGFR3
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Gene-Disease Validity (ClinGen)
Crouzon syndrome-acanthosis nigricans syndrome · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

7 total gene-disease associations curated

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
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ClinVar Variants
76 unique Pathogenic / Likely Pathogenic· 200 VUS of 500 total submissions
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Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
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GeneReview available — FGFR3
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
0.60LOEUF
pLI 0.000
Z-score 3.48
OE 0.39 (0.260.60)
Tolerant

Typical tolerance to LoF variation

Missense Constraint
1.26Z-score
OE missense 0.85 (0.780.92)
458 obs / 540.2 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.39 (0.260.60)
00.351.4
Missense OE0.85 (0.780.92)
00.61.4
Synonymous OE1.27
01.21.6
LoF obs/exp: 15 / 38.2Missense obs/exp: 458 / 540.2Syn Z: -3.39
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveFGFR3-related achondroplasiaGOFAD
definitiveFGFR3-related camptodactyly tall stature and hearing loss syndromeOTHERAD
definitiveFGFR3-related thanatophoric dysplasia, type 1GOFAD
definitiveFGFR3-related thanatophoric dysplasia, type 2GOFAD
definitiveFGFR3-related hypochondroplasiaGOFAD
definitiveFGFR3-related Muenke syndromeGOFAD
definitiveFGFR3-related lacrimo-auriculo-dento-digital syndrome (LADD)OTHERAD
definitiveFGFR3-related Crouzon syndrome with acanthosis nigricansGOFAD
DN
0.75top 25%
GOF
0.80top 10%
LOF
0.3164th %ile

This gene has evidence for multiple mechanisms of pathogenicity (gain-of-function and dominant-negative). Both the Badonyi & Marsh prediction and the broader genomic evidence point to gain-of-function as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

GOFprediction above median · 1 literature citation
DNprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Literature Evidence

GOFAchondroplasia (ACH; MIM #100800) is an autosomal dominant genetic disease caused by gain-of-function mutations in FGFR3 gene and results in short-limb dwarfism.PMID:33848795

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

500 submitted variants in ClinVar

Classification Summary

Pathogenic69
Likely Pathogenic7
VUS200
Likely Benign174
Benign20
Conflicting16
69
Pathogenic
7
Likely Pathogenic
200
VUS
174
Likely Benign
20
Benign
16
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
4
65
0
69
Likely Pathogenic
1
3
3
0
7
VUS
11
167
17
5
200
Likely Benign
4
19
61
90
174
Benign
0
1
13
6
20
Conflicting
16
Total16194159101486

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

FGFR3 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Lymphoma, Non-HodgkinMultiple MyelomaAdvanced Solid Tumors

Canadian Profiling and Targeted Agent Utilization Trial (CAPTUR)

RECRUITING
NCT03297606Phase PHASE2Canadian Cancer Trials GroupStarted 2018-03-23
OlaparibDasatinibNivolumab plus Ipilimumab
Lung Cancer

Feasibility of Targeted Bronchial Washing for Molecular Testing by Next Generation Sequencing in Early-stage Lung Cancer

ACTIVE NOT RECRUITING
NCT06301295Phase NAPusan National University HospitalStarted 2024-05-29
Ultarthin bronchoscopy with intratumoral washing
Non-Muscle Invasive Bladder Urothelial CarcinomaRecurrent Non-Muscle Invasive Bladder Urothelial Carcinoma

A Randomized Trial of Bicalutamide in Non-Muscle Invasive Bladder Cancer

RECRUITING
NCT05521698Phase PHASE1University of Wisconsin, MadisonStarted 2026-05
BicalutamideBiopsy ProcedureBiospecimen Collection
Intrahepatic Cholangiocarcinoma (Icc)CholangiocarcinomaOther Solid Tumors, Adult

A Study of an FGFR2/3 Inhibitor (CGT4859) in Patients With Cholangiocarcinoma and Other Advanced Solid Tumors

ACTIVE NOT RECRUITING
NCT06777316Phase PHASE1, PHASE2Cogent Biosciences, Inc.Started 2025-01-22
CGT4859
Bladder CancerRecurrent Bladder CancerFGFR3 Gene Mutation

A Study of Oral Erdafitinib in People With Recurrent Non-Invasive Bladder Cancer

ACTIVE NOT RECRUITING
NCT04917809Phase PHASE2Memorial Sloan Kettering Cancer CenterStarted 2022-02-17
Erdafitinib
Low Grade Upper Tract Urothelial Carcinoma

Phase 2A/B Efficacy and Safety of Dabogratinib in Participants With Low Grade Upper Tract Urothelial Carcinoma

RECRUITING
NCT07265947Phase PHASE2Tyra Biosciences, IncStarted 2025-12-22
Dabogratinib (TYRA-300) 60mgDabogratinib (TYRA-300) 80mgDabogratinib (TYRA-300) TBD
Locally Advanced Bladder Urothelial CarcinomaLocally Advanced Renal Pelvis Urothelial CarcinomaLocally Advanced Ureter Urothelial Carcinoma

Testing Combination Erdafitinib and Enfortumab Vedotin in Metastatic Bladder Cancer After Treatment With Chemotherapy and Immunotherapy

ACTIVE NOT RECRUITING
NCT04963153Phase PHASE1National Cancer Institute (NCI)Started 2022-07-07
Biospecimen CollectionBone ScanComputed Tomography
Metastatic Hepatocellular CarcinomaSolid TumorsSolid Tumor, Adult

Safety and Preliminary Anti-Tumor Activity of TYRA-430 in Advanced Hepatocellular Carcinoma and Other Solid Tumors With Activating FGF/FGFR Pathway Aberrations

RECRUITING
NCT06915753Phase PHASE1Tyra Biosciences, IncStarted 2025-04-24
TYRA-430
Advanced Malignant Solid NeoplasmAnn Arbor Stage III Non-Hodgkin LymphomaAnn Arbor Stage IV Non-Hodgkin Lymphoma

Targeted Therapy Directed by Genetic Testing in Treating Pediatric Patients With Relapsed or Refractory Advanced Solid Tumors, Non-Hodgkin Lymphomas, or Histiocytic Disorders (The Pediatric MATCH Screening Trial)

ACTIVE NOT RECRUITING
NCT03155620Phase PHASE2National Cancer Institute (NCI)Started 2017-07-31
Biopsy ProcedureBiospecimen CollectionBone Marrow Aspiration and Biopsy
Urothelial Carcinoma (UC)Bladder (Urothelial, Transitional Cell) CancerLiquid Biopsy

Using Liquid Biopsy Testing to Identify, Monitor, Predict Recurrence in Urothelial Carcinoma

RECRUITING
NCT07441499Tianjin Medical University Second HospitalStarted 2026-03
Multi-Component Liquid Biopsy for Urothelial Carcinoma
Urinary Bladder NeoplasmsNeoplasm MetastasisUreteral Neoplasms

FORAGER-1: A Study of LOXO-435 (LY3866288) in Participants With Cancer With a Change in a Gene Called FGFR3

RECRUITING
NCT05614739Phase PHASE1Eli Lilly and CompanyStarted 2023-01-12
LOXO-435Pembrolizumabenfortumab vedotin
Locally Advanced Urothelial CarcinomaMetastatic Urothelial CarcinomaSolid Tumor

Safety and Preliminary Anti-Tumor Activity of TYRA-300 in Advanced Urothelial Carcinoma and Other Solid Tumors With FGFR3 Gene Alterations

ACTIVE NOT RECRUITING
NCT05544552Phase PHASE1, PHASE2Tyra Biosciences, IncStarted 2022-11-22
TYRA-300
Clinical Literature
Open Research Assistant →
Key Publications
Landmark & review papers · by relevance
PubMed
Bladder cancer.
Dyrskjøt L et al.·Nat Rev Dis Primers
2023Review
Achondroplasia: a comprehensive clinical review.
Pauli RM·Orphanet J Rare Dis
2019Review
New treatments for children with achondroplasia.
Savarirayan R et al.·Lancet Child Adolesc Health
2024Review
Top 5 results · since 2015Search PubMed ↗