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Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential

Idelalisib is a first-in-class, oral, selective phosphatidylinositol 3-kinase δ inhibitor that offers a chemotherapy-free option for patients with relapsed or refractory (R/R) indolent non-Hodgkin lymphoma (iNHL). Clinical trials in iNHL have evaluated idelalisib as monotherapy and as combination th...

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Autor principal: Barrientos, Jacqueline C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876096/
https://www.ncbi.nlm.nih.gov/pubmed/27274288
http://dx.doi.org/10.2147/OTT.S102573
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author Barrientos, Jacqueline C
author_facet Barrientos, Jacqueline C
author_sort Barrientos, Jacqueline C
collection PubMed
description Idelalisib is a first-in-class, oral, selective phosphatidylinositol 3-kinase δ inhibitor that offers a chemotherapy-free option for patients with relapsed or refractory (R/R) indolent non-Hodgkin lymphoma (iNHL). Clinical trials in iNHL have evaluated idelalisib as monotherapy and as combination therapy with rituximab, bendamustine, and rituximab + bendamustine. When administered to heavily pretreated patients with R/R iNHL, idelalisib monotherapy or combination therapy showed durable antitumor activity accompanied by sustained or improved quality-of-life outcomes. Idelalisib has an acceptable safety profile; however, serious or fatal diarrhea/colitis, hepatoxicity, pneumonitis, and intestinal perforation have occurred in treated patients. Selective inhibition of phosphatidylinositol 3-kinase δ with idelalisib is a valuable addition to available treatment options for patients with iNHL, many of whom do not respond to or cannot tolerate chemoimmunotherapy. Two Phase III, randomized, placebo-controlled trials of idelalisib as combination therapy with rituximab or bendamustine + rituximab and a Phase I trial of idelalisib in combination with the Bruton’s tyrosine kinase inhibitor ONO/GS-4059 in R/R B-cell malignancies are currently ongoing. A Phase III monotherapy trial in previously treated follicular lymphoma or small lymphocytic lymphoma is planned. The development of other kinase inhibitors for the treatment of iNHL raises the potential for new treatment combinations. Additional research is needed to determine optimal therapy (monotherapy vs combination regimens), treatment sequencing, and long-term management.
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spelling pubmed-48760962016-06-07 Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential Barrientos, Jacqueline C Onco Targets Ther Review Idelalisib is a first-in-class, oral, selective phosphatidylinositol 3-kinase δ inhibitor that offers a chemotherapy-free option for patients with relapsed or refractory (R/R) indolent non-Hodgkin lymphoma (iNHL). Clinical trials in iNHL have evaluated idelalisib as monotherapy and as combination therapy with rituximab, bendamustine, and rituximab + bendamustine. When administered to heavily pretreated patients with R/R iNHL, idelalisib monotherapy or combination therapy showed durable antitumor activity accompanied by sustained or improved quality-of-life outcomes. Idelalisib has an acceptable safety profile; however, serious or fatal diarrhea/colitis, hepatoxicity, pneumonitis, and intestinal perforation have occurred in treated patients. Selective inhibition of phosphatidylinositol 3-kinase δ with idelalisib is a valuable addition to available treatment options for patients with iNHL, many of whom do not respond to or cannot tolerate chemoimmunotherapy. Two Phase III, randomized, placebo-controlled trials of idelalisib as combination therapy with rituximab or bendamustine + rituximab and a Phase I trial of idelalisib in combination with the Bruton’s tyrosine kinase inhibitor ONO/GS-4059 in R/R B-cell malignancies are currently ongoing. A Phase III monotherapy trial in previously treated follicular lymphoma or small lymphocytic lymphoma is planned. The development of other kinase inhibitors for the treatment of iNHL raises the potential for new treatment combinations. Additional research is needed to determine optimal therapy (monotherapy vs combination regimens), treatment sequencing, and long-term management. Dove Medical Press 2016-05-18 /pmc/articles/PMC4876096/ /pubmed/27274288 http://dx.doi.org/10.2147/OTT.S102573 Text en © 2016 Barrientos. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Barrientos, Jacqueline C
Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential
title Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential
title_full Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential
title_fullStr Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential
title_full_unstemmed Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential
title_short Idelalisib for the treatment of indolent non-Hodgkin lymphoma: a review of its clinical potential
title_sort idelalisib for the treatment of indolent non-hodgkin lymphoma: a review of its clinical potential
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876096/
https://www.ncbi.nlm.nih.gov/pubmed/27274288
http://dx.doi.org/10.2147/OTT.S102573
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