Idelalisib, a selective inhibitor of phosphatidylinositol 3-kinase-delta, as therapy for previously treated indolent non-Hodgkin lymphoma BLOOD Flinn, I. W., Kahl, B. S., Leonard, J. P., Furman, R. R., Brown, J. R., Byrd, J. C., Wagner-Johnston, N. D., Coutre, S. E., Benson, D. M., Peterman, S., Cho, Y., Webb, H. K., Johnson, D. M., Yu, A. S., Ulrich, R. G., Godfrey, W. R., Miller, L. L., Spurgeon, S. E. 2014; 123 (22): 3406-3413


Idelalisib (GS-1101, CAL-101), an oral inhibitor of phosphatidylinositol 3-kinase-d, was evaluated in a phase I study in 64 patients with relapsed indolent non-Hodgkin lymphoma (iNHL). Patients had a median (range) age of 64 (32-91) years, 34 (53%) had bulky disease (=1 lymph nodes =5 cm), and 37 (58%) had refractory disease. Patients had received a median (range) of 4 (1-10) prior therapies. Eight dose regimens of idelalisib were evaluated; idelalisib was taken once or twice daily continuously at doses ranging from 50 to 350 mg. After 48 weeks, patients still benefitting (n = 19; 30%) enrolled into an extension study. Adverse events (AEs) occurring in 20% or more patients (total%/grade =3%) included diarrhea (36/8), fatigue (36/3), nausea (25/3), rash (25/3), pyrexia (20/3), and chills (20/0). Laboratory abnormalities included neutropenia (44/23), anemia (31/5), thrombocytopenia (25/11), and serum transaminase elevations (48/25). Twelve (19%) patients discontinued therapy due to AEs. Idelalisib induced disease regression in 46/54 (85%) of evaluable patients achieving an overall response rate of 30/64 (47%), with 1 patient having a complete response (1.6%). Median duration of response was 18.4 months, median progression-free survival was 7.6 months. Idelalisib is well tolerated and active in heavily pretreated, relapsed/refractory patients with iNHL. These trials were registered at as NCT00710528 and NCT01090414.

View details for DOI 10.1182/blood-2013-11-538546

View details for PubMedID 24615776