Dr. Leonard on the Potential for Combinations With PI3K Inhibitors in Follicular Lymphoma

Video

John P. Leonard, MD, discusses the potential for combination regimens with PI3K inhibitors in follicular lymphoma.

John P. Leonard, MD, The Richard T. Silver Distinguished Professor of Hematology and Medical Oncology, professor of medicine, executive vice chairman, Department of Medicine, senior associate dean for Innovation and Initiatives, Weill Cornell Medicine, attending physician, NewYork-Presbyterian Hospital, discusses the potential for combination regimens with PI3K inhibitors in follicular lymphoma.

Currently, the FDA-approved PI3K inhibitors—copanlisib (Aliqopa), idelalisib (Zydelig), duvelisib (Copiktra), and umbralisib (Ukoniq)—are reserved for patients with relapsed/refractory follicular lymphoma, Leonard says. Moreover, the agents are typically utilized following chemotherapy with or without a CD20-directed antibody, Leonard says. Then, patients may receive an additional CD20-directed antibody, such as rituximab (Rituxan), in combination with chemotherapy or lenalidomide (Revlimid) as second-line therapy, Leonard says. PI3K inhibitors are considered following one or more lines of prior chemoimmunotherapy in patients who are often refractory to rituximab and lenalidomide, Leonard explains.

However, findings from the phase 3 CHRONOS-3 trial (NCT02367040) demonstrated a median progression-free survival of 21.5 months with copanlisib in combination with rituximab vs 13.8 months with rituximab plus placebo in patients with relapsed/refractory indolent non-Hodgkin lymphoma, including follicular lymphoma, Leonard says. As such, it is possible that combination strategies featuring PI3K inhibitors will move into earlier lines of therapy, concludes Leonard. 

Related Videos
Petros Grivas, MD, PhD, professor, Clinical Research Division, Fred Hutchinson Cancer Center; professor, Division of Hematology and Oncology, University of Washington (UW) School of Medicine; clinical director, Genitourinary Cancers Program, UW Medicine
Somedeb Ball, MBBS, assistant professor, medicine, Division of Hematology Oncology, Department of Medicine, Vanderbilt University Medical Center
Phillip J. Koo, MD
Gabriella Smith, MD
Mikkael A. Sekeres, MD, MS
Francesco Di Meo, PhD
Ko Un “Clara” Park, MD
Naseema Gangat, MBBS
Erin Frances Cobain, MD
Pashtoon Murtaza Kasi, MD, MS