Martin Dreyling, MD, PhD
A majority of patients with relapsed or refractory indolent lymphoma responded to treatment with the PI3K dual-isoform inhibitor copanlisib, according to results from the phase II CHRONOS-1 trial.
The B-cell receptor (BCR) PI3K signaling pathways have a key role in the evolution and progression of indolent lymphomas. The understanding provided a rationale for targeted inhibition of the pathways as a treatment strategy for relapsed/refractory indolent B-cell lymphomas, said Dreyling.
Investigation of strategies targeting BCR and PI3K led to the development of the oral PI3K delta isoform-selective inhibitor idelalisib (Zydelig) for chronic lymphocytic leukemia, follicular lymphoma, and small lymphocytic lymphoma (SLL). In the United States, idelalisib prescribing information includes a black-box warning about a risk of severe or fatal diarrhea, colitis, hepatotoxicity, pneumonitis, and intestinal perforation. Additionally, reported high rates of serious adverse events led to early termination of some clinical trials involving idelalisib in combination with other therapies (Expert Rev Anticancer Ther. 2017;17:271-279).
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