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http://dx.doi.org/10.1016/j.medcli.2022.01.011DOI Listing

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Article Synopsis
  • - The study focuses on the safety of PI3K inhibitors (like alpelisib and copanlisib) used in cancer treatment, revealing significant adverse effects related to metabolic and gastrointestinal disorders.
  • - Using data from the FDA's Adverse Event Reporting System, researchers found unique and common adverse effects among different PI3K inhibitors, including colitis and dehydration, with alpelisib linked to specific issues like intestinal perforation.
  • - The findings indicate varying safety profiles across the five PI3K inhibitors, which can help in making informed decisions about drug selection and future research directions.
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Objectives: We examined the efficacy and toxicity of the PI3Kδ inhibitor idelalisib in combination with rituximab salvage therapy in consecutively identified Swedish patients with chronic lymphocytic leukemia (CLL).

Methods And Results: Thirty-seven patients with relapsed/refractory disease were included. The median number of prior lines of therapy was 3 (range 1-11); the median age was 69 years (range 50-89); 22% had Cumulative Illness Rating Scale (CIRS) >6 and 51% had del(17p)/TP53 mutation.

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The phosphatidylinositol 3-kinase (PI3K) pathway plays a key role in cancer progression and in host immunity. Idelalisib was the first of this class to be approved with the second-generation Pi3 kinase inhibitors copanlisib, duvelisib and umbralisib, subsequently being approved in the United States. Real-world data are lacking, however, in relation to the incidence and toxicity of Pi3 kinase inhibitor-induced colitis.

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Purpose Of Review: Treatment of non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) underwent paradigm shifts, with targeted agents rapidly displacing chemotherapy. Phosphoinotiside-3 kinase (PI3K) is essential for survival and proliferation of neoplastic B cells and has proven a tractable target in NHL, with four agents receiving FDA approval in the last decade. This review summarizes key data and challenges associated with use of PI3K inhibitors in routine practice.

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