Idelalisib for the treatment of non-Hodgkin lymphoma

ABSTRACT

Introduction

B-cell Non-Hodgkin lymphomas (B-NHLs) include a number of disease subtypes, each defined by the tempo of disease progression and the identity of the cancerous cell. Idelalisib is a potent, selective inhibitor of the delta isoform of phosphatidylinositol-3-kinase (PI3K), a lipid kinase whose over-activity in B-NHL drives disease progression. Idelalisib has demonstrated activity in indolent B-NHL (iB-NHL) and is approved for use as monotherapy in patients with follicular lymphoma and small lymphocytic lymphoma and in combination with rituximab in patients with chronic lymphocytic leukemia.

Areas Covered

Herein we review the development and pharmacology of idelalisib, its safety and efficacy in clinical studies of iB-NHL, and its potential for inclusion in future applications in iB-NHL and in combination with other therapies.

Expert Opinion

Idelalisib adds to the growing arsenal of iB-NHL pharmacotherapeutics and to the progression of the field toward precision agents with good efficacy and reduced toxicities. Nevertheless, idelalisib carries important risks that require careful patient counseling and monitoring. The appropriate sequencing of idelalisib with other proven treatment options in addition to its potential for combination with established or novel drugs will be borne out in ongoing and planned investigations.

KEYWORDS:

• Idelalisib
• B-cell
• lymphoma
• indolent

Declaration of Interest

This work was supported by research funding from NCI P01CA44991, K24CA184039, Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Cancer Center Support Grant P30 CA015704, and gifts from Frank and Betty Vandermeer, Don and Debbie Hunkins, and the Mary Aileen Wright Memorial Fund. S.A.G. received support from NIH 5T32HL007093. A Gopal has received consulting fees from Seattle Genetics Inc, Gilead Sciences, Janssen Pharmaceuticals and Spectrum Pharmaceuticals within the last 12 months. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed