Idelalisib therapy of indolent B-cell malignancies: chronic lymphocytic leukemia and small lymphocytic or follicular lymphomas.
Idelalisib therapy of indolent B-cell malignancies: chronic lymphocytic leukemia and small lymphocytic or follicular lymphomas.
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DOI：
10.2147/blctt.s73530
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Hill BT
中科院分区：
文献类型：
--
作者：
Madanat YF;Smith MR;Almasan A;Hill BT
慢性淋巴细胞性白血病、小淋巴细胞性淋巴瘤和滤泡性淋巴瘤是惰性B细胞淋巴增生性疾病，主要影响老年人群。尽管大多数需要治疗的患者从常规化疗剂以及单克隆抗体中获得显著益处，但需要毒性更小且更有效的治疗。抑制B细胞受体信号通路的新型药物在这些疾病中显示出有希望的结果。Idelalisib是一种有效的选择性口服磷脂酰肌醇3-激酶δ抑制剂，在B细胞恶性肿瘤中显示出显著的临床活性。在这篇综述中，我们总结了使用idelalisib作为单药治疗或与利妥昔单抗联合治疗复发/难治性疾病的临床试验数据。不良反应包括自身免疫性疾病，如转氨酶升高、结肠炎和肺炎。鉴于idelalisib的功效和可管理的毒性特征，它正越来越多地被纳入惰性B细胞恶性肿瘤的治疗中。
Chronic lymphocytic leukemia, small lymphocytic lymphoma, and follicular lymphoma are indolent B-cell lymphoproliferative disorders that mainly affect an older population. Although the majority of patients in need of treatment derive significant benefit from conventional chemotherapeutic agents as well as monoclonal antibodies, less toxic and more effective treatments are needed. Novel agents that inhibit the B-cell receptor signaling pathway have shown promising outcomes in these disorders. Idelalisib is a potent selective oral inhibitor of phosphatidylinositol 3-kinase delta and has shown significant clinical activity in B-cell malignancies. In this review, we summarize the clinical trial data using idelalisib as monotherapy or in combination with rituximab for the treatment of relapsed/refractory disease. The adverse effect profile includes autoimmune disorders such as transaminitis, colitis, and pneumonitis. Given the efficacy and manageable toxicity profile of idelalisib, it is being increasingly incorporated into the management of indolent B-cell malignancies.