^
    16d
    Six-year follow-up of phase II study exploring chemo-free treatment association with idelalisib and obinutuzumab in symptomatic relapsed/ refractory patients with Waldenström's macroglobulinemia. (PubMed, Ann Hematol)
    We present the 6-year update of a phase 2 study evaluating the combination of obinutuzumab and idelalisib in relapse/refractory Waldenstrom macroglobulinemia. Moreover, ibrutinib remains an effective treatment after this combination. This study was registered on the clinicaltrial.gov web (NCT02962401, November 9, 2016).
    P2 data • Journal
    |
    TP53 (Tumor protein P53) • CXCR4 (Chemokine (C-X-C motif) receptor 4)
    |
    TP53 mutation • CXCR4 mutation
    |
    Imbruvica (ibrutinib) • Gazyva (obinutuzumab) • Zydelig (idelalisib)
    19d
    Vertical targeting of the PI3K/AKT pathway at multiple points is synergistic and effective for non-Hodgkin lymphoma. (PubMed, Exp Hematol Oncol)
    We studied this problem using cell lines representing diffuse large B-cell lymphoma (SUDHL-4 and OCI-Ly7), a genetically-encoded live-cell reporter of AKT activity, and 3 small-molecule inhibitors targeting different levels of the pathway: idelalisib (PI3Kδ), GSK2334470 (PDPK1), and ipatasertib (AKT)...Combining all 3 inhibitors produced sustained inhibition of AKT activity, was broadly synergistic at reducing viable cell number, enabled substantially lower doses of each inhibitor to be used, and was enhanced further by the mTOR inhibitor rapamycin...In a syngeneic mouse cell line model of lymphoma (A20), the triple combination showed antitumor activity and no evidence of toxicity. Our findings provide proof of concept suggesting further study of the safety and efficacy of low-dose multilevel PI3K/AKT pathway inhibition, for lymphoma and perhaps other cancers.
    Journal
    |
    PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • PDPK1 (3-Phosphoinositide dependent protein kinase 1)
    |
    Zydelig (idelalisib) • ipatasertib (RG7440) • sirolimus • GSK2334470
    1m
    Hyperglycemia secondary to phosphatidylinositol-3 kinase (PI3K) inhibition. (PubMed, Endocrinol Diabetes Metab Case Rep)
    Targeting this pathway has been approved as a therapeutic option for breast cancer and lymphoma (e.g. alpelisib, idelalisib), and there are several clinical trials underway in additional types of cancer...We report the case of a 53-year-old female with metastatic breast cancer who developed acute grade 3 hyperglycemia from a novel PI3K inhibitor, inavolisib...All patients treated with PI3K inhibitors should receive pre-treatment screening for hyperglycemia, lifestyle advice, and a glucometer to measure fasting BGL and 2-h post-dinner BGL levels twice per week for at least the first 30 days of treatment. Insulin or insulin secretagogues (e.g. sulfonylurea) may inhibit the anti-tumor activity of PI3K inhibitors, and thus treatment of PI3K inhibitor-associated hyperglycemia should prefer alternative approaches such as a low carbohydrate diet, metformin, SGLT2i, or dose reduction of the PI3K inhibitor.
    Journal
    |
    IR (Insulin receptor)
    |
    Piqray (alpelisib) • Zydelig (idelalisib) • metformin • Itovebi (inavolisib)
    1m
    FoxO1/Rictor axis induces a non-genetic adaptation to Ibrutinib via Akt activation in chronic lymphocytic leukemia. (PubMed, J Clin Invest)
    Knock-out or inhibition of FoxO1 or Rictor led to a dramatic decrease in Akt phosphorylation and growth disadvantage for malignant B cells in the presence of ibrutinib (or PI3K inhibitor idelalisib) in vitro and in vivo. FoxO1/Rictor/pAktS473 axis represents an early non-genetic adaptation to BCR inhibitor therapy not requiring PI3Kδ or BTK kinase activity. We further demonstrate that FoxO1 can be targeted therapeutically, and its inhibition induces CLL cells' apoptosis alone or in combination with BTK inhibitors (ibrutinib, acalabrutinib, pirtobrutinib) and blocks their proliferation triggered by T-cell factors (CD40L, IL-4, and IL-21).
    Journal
    |
    PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • CD40LG (CD40 ligand) • IL21 (Interleukin 21) • IL4 (Interleukin 4)
    |
    Imbruvica (ibrutinib) • Calquence (acalabrutinib) • Zydelig (idelalisib) • Jaypirca (pirtobrutinib)
    1m
    A Study of Idelalisib (GS1101, CAL101) + Ofatumumab in Previously Untreated CLL/SLL (clinicaltrials.gov)
    P2, N=27, Completed, Dana-Farber Cancer Institute | Active, not recruiting --> Completed | N=50 --> 27
    Trial completion • Enrollment change
    |
    CD19 (CD19 Molecule) • CCND1 (Cyclin D1) • CD5 (CD5 Molecule) • FCER2 (Fc Fragment Of IgE Receptor II)
    |
    Chr t(11;14) • CCND1 overexpression
    |
    Zydelig (idelalisib) • Arzerra (ofatumumab)
    1m
    Dose Escalation and Dose Expansion Study of Tirabrutinib in Combination With Other Targeted Anti-cancer Therapies in Adults With B-cell Malignancies (clinicaltrials.gov)
    P1, N=203, Terminated, Gilead Sciences | Active, not recruiting --> Terminated; The goal of the study was to improve tolerability while maintaining or increasing efficacy. The results of this study showed no efficacy advantage although the combinations were well tolerated.
    Trial termination • Combination therapy
    |
    Gazyva (obinutuzumab) • Zydelig (idelalisib) • entospletinib (GS-9973) • Velexbru (tirabrutinib)
    2ms
    PI3Kδ activation, IL6 overexpression, and CD37 loss cause resistance to naratuximab emtansine in lymphomas. (PubMed, Blood Adv)
    Anti-IL6 antibody tocilizumab improved the ADC's cytotoxic activity in CD37+ cells...Adding idelalisib or venetoclax overcame resistance in the resistant derivative and improved the cytotoxic activity in the parental cells. In conclusion, targeting B-cell lymphoma with the naratuximab emtansine showed vigorous anti-tumor activity as a single agent, which was also observed in models bearing genetic lesions associated with inferior outcomes, such as MYC translocations and TP53 inactivation or R-CHOP resistance. Resistant DLBCL models identified active combinations of naratuximab emtansine with drugs targeting IL6, PI3Kδ, and BCL2.
    Journal • IO biomarker
    |
    TP53 (Tumor protein P53) • MYC (V-myc avian myelocytomatosis viral oncogene homolog) • BCL2 (B-cell CLL/lymphoma 2) • MCL1 (Myeloid cell leukemia 1) • IL6 (Interleukin 6) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • CD37 (CD37 Molecule)
    |
    MYC translocation • CD37 expression • PIK3CD mutation
    |
    Venclexta (venetoclax) • Rituxan (rituximab) • Zydelig (idelalisib) • Actemra IV (tocilizumab) • naratuximab emtansine (DEBIO 1562)
    2ms
    1630GCC: Zydelig Maintenance in B-Cell Non-Hodgkin's Lymphoma After Autologous Stem Cell Transplantation (clinicaltrials.gov)
    P2, N=17, Active, not recruiting, University of Maryland, Baltimore | N=34 --> 17
    Enrollment change
    |
    Zydelig (idelalisib)
    2ms
    A highly selective PI3Kδ inhibitor BGB-10188 shows superior preclinical anti-tumor activities and decreased on-target side effects on colon. (PubMed, Neoplasia)
    BGB-10188 showed significant antitumor effects in human B cell lymphoma xenograft models as single agent or in combination with the BTK inhibitor zanubrutinib. BGB-10188 showed significant Treg inhibition in blood but not in colon, along with less drug accumulation in colon compared with idelalisib, which is an approved PI3Kdelta inhibitor with high incidence of gastrointestinal side effects in clinic. In summary, BGB-10188 is a novel PI3Kδ inhibitor with high selectivity, potency and improved safety profile shown in preclinical studies, which is showing the potential as a best-in-class PI3Kδ inhibitor.
    Preclinical • Journal • Adverse events
    |
    PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
    |
    Brukinsa (zanubrutinib) • Zydelig (idelalisib) • BGB-10188
    4ms
    Post-marketing safety concern of PI3K inhibitors in the cancer therapies: an 8-year disproportionality analysis from the FDA adverse event reporting system. (PubMed, Expert Opin Drug Saf)
    Alpelisib (inhibiting PI3Kα), copanlisib (inhibiting PI3Kα andPI3Kδ), duvelisib (inhibiting PI3Kδ and PI3Kγ), and idelalisib (inhibitingPI3Kδ) were developed to target the PI3K pathway...The safety profiles of the five PI3K inhibitorsvary concerning adverse events. These findings could guide drug selection andinform future prospective research.
    P4 data • Journal • Adverse events
    |
    PIK3CA (Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) • PIK3CG (Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Gamma) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
    |
    Piqray (alpelisib) • Aliqopa (copanlisib) • Zydelig (idelalisib) • Copiktra (duvelisib) • Ukoniq (umbralisib)
    5ms
    Dose Escalation and Dose Expansion Study of Tirabrutinib in Combination With Other Targeted Anti-cancer Therapies in Adults With B-cell Malignancies (clinicaltrials.gov)
    P1, N=203, Active, not recruiting, Gilead Sciences | Trial completion date: Dec 2025 --> Dec 2024 | Trial primary completion date: Dec 2025 --> Dec 2024
    Trial completion date • Trial primary completion date • Combination therapy
    |
    Gazyva (obinutuzumab) • Zydelig (idelalisib) • entospletinib (GS-9973) • Velexbru (tirabrutinib)
    5ms
    ACY-1215 in Combination With BCR Pathway Inhibitors in Relapsed CLL (clinicaltrials.gov)
    P1, N=3, Active, not recruiting, Dana-Farber Cancer Institute | Trial completion date: Apr 2026 --> Apr 2027 | Trial primary completion date: Apr 2024 --> Apr 2026
    Trial completion date • Trial primary completion date • Combination therapy
    |
    Imbruvica (ibrutinib) • Zydelig (idelalisib) • rocilinostat (ACY-1215)
    6ms
    PI3K inhibitor idelalisib enhances the anti-tumor effects of CDK4/6 inhibitor palbociclib via PLK1 in B-cell lymphoma. (PubMed, Cancer Lett)
    Furthermore, we also validated the pharmacological efficacy of CDK4/6 inhibitor palbociclib and its synergy effect with PI3K inhibitor idelalisib utilizing in vitro cell lines and in vivo cell-derived xenograft (CDX) and patient-derived xenograft (PDX) mouse models. Our results provided sufficient pre-clinical evidence to support the potential combination of palbociclib and idelalisib for DLBCL and MCL patients.
    Journal
    |
    CDKN2A (Cyclin Dependent Kinase Inhibitor 2A) • CCND1 (Cyclin D1) • CDKN2B (Cyclin Dependent Kinase Inhibitor 2B) • PLK1 (Polo Like Kinase 1)
    |
    Ibrance (palbociclib) • Zydelig (idelalisib)
    6ms
    Combined inhibition of class 1-PI3K-alpha and delta isoforms causes senolysis by inducing p21WAF1/CIP1 proteasomal degradation in senescent cells. (PubMed, Cell Death Dis)
    The Pan-PI3K-inhibitor wortmannin and its clinical derivative, PX-866, were identified to act as senolytics...Other Pan-PI3K inhibitors, such as the FDA-approved drug BAY80-6946 (Copanlisib, Aliqopa®), also efficiently and specifically eliminated senescent cells. Interestingly, only the simultaneous inhibition of both PI3K class I alpha (with BYL-719 (Alpelisib, Piqray®)) and delta (with CAL-101 (Idelalisib, Zydelig®)) isoforms was sufficient to induce senolysis, whereas single application of these inhibitors had no effect...This led to a timely induction of apoptosis in senescent tumor cells. Taken together, the senolytic properties of PI3K-inhibitors reveal a novel dimension of these promising compounds, which holds particular potential when employed alongside DNA damaging agents in combination tumor therapies.
    Journal
    |
    PIK3CA (Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) • CDKN1A (Cyclin-dependent kinase inhibitor 1A)
    |
    Piqray (alpelisib) • Aliqopa (copanlisib) • Zydelig (idelalisib) • sonolisib (PX 866)
    7ms
    A novel role for the phosphatidylinositol-4,5-bisphosphate 3-kinase delta isoform in hepatocellular proliferation. (PubMed, Am J Pathol)
    A regulatory role for p110δ signaling in mouse and rat hepatocytes through MET and EGFR was further verified using hepatocyte primary cultures, in the presence or absence of CAL101. Combined, this data supports a role for p110δ as a downstream regulator of normal hepatocytes when stimulated to proliferate.
    Journal
    |
    EGFR (Epidermal growth factor receptor) • HER-2 (Human epidermal growth factor receptor 2) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
    |
    Zydelig (idelalisib)
    7ms
    TYM-3-98, a novel selective inhibitor of PI3Kδ, demonstrates promising preclinical antitumor activity in B-cell lymphomas. (PubMed, Life Sci)
    Our findings establish TYM-3-98 as a promising PI3Kδ inhibitor for the treatment of B-cell lymphoma.
    Preclinical • Journal
    |
    PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
    |
    Zydelig (idelalisib)
    7ms
    BRUIN CLL-321: Study of LOXO-305 Versus Investigator's Choice (IdelaR or BR) in Patients With Previously Treated Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL) (clinicaltrials.gov)
    P3, N=250, Active, not recruiting, Loxo Oncology, Inc. | Recruiting --> Active, not recruiting
    Enrollment closed
    |
    Rituxan (rituximab) • Zydelig (idelalisib) • Jaypirca (pirtobrutinib) • bendamustine
    8ms
    A Study to Compare the Efficacy and Safety of Lisocabtagene Maraleucel vs Investigator's Choice Options in Adult Participants With Relapsed or Refractory Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma, Whose Disease Has Failed Treatment With Both BTKi and BCL2i Therapies (clinicaltrials.gov)
    P3, N=0, Withdrawn, Juno Therapeutics, Inc., a Bristol-Myers Squibb Company | N=200 --> 0 | Not yet recruiting --> Withdrawn
    Enrollment change • Trial withdrawal
    |
    Rituxan (rituximab) • cyclophosphamide • Zydelig (idelalisib) • Breyanzi (lisocabtagene maraleucel) • bendamustine • fludarabine IV • Belrapzo (bendamustine RTD)
    8ms
    Blocking Orai1 constitutive activity inhibits B-cell cancer migration and synergistically acts with drugs to reduce B-CLL cell survival. (PubMed, Eur J Pharmacol)
    Finally, the added value of Orai1 inhibitors in combination with B-CLL drugs (ibrutinib, idelalisib, rituximab, and venetoclax) on B-CLL survival was tested, showing an additive/synergistic effect including in the B-cell cancer lines. To conclude, this study highlights the pathophysiological role of the Ca2+ channel Orai1 in B-cell cancers, and pave the way for the use of ORAI1 modulators as a plausible therapeutic strategy.
    Journal
    |
    CASP3 (Caspase 3)
    |
    Venclexta (venetoclax) • Imbruvica (ibrutinib) • Rituxan (rituximab) • Zydelig (idelalisib)
    9ms
    Glucose Metabolism in Acute Myeloid Leukemia Cell Line Is Regulated via Combinational PI3K/AKT/mTOR Pathway Inhibitors. (PubMed, Iran J Pharm Res)
    HL-60 cells were treated with Idelalisib, MK-2206, and Everolimus, which respectively are selective inhibitors of phosphatidylinositol-3-kinase (PI3K), AKT, and the mammalian target of rapamycin (mTOR), either individually or in combination. A combination of PI3K/AKT/mTOR pathway inhibitors regulates the expression of genes involved in glycolysis, pyruvate dehydrogenase complex (PDH), and the tricarboxylic acid (TCA) cycle and interferes with metabolic reprogramming and immune evasion mechanisms of AML leukemic cells. Combinational therapy approaches to block these pathways might be a promising and novel therapeutic strategy for targeting the metabolic requirements of AML cells.
    Preclinical • Journal
    |
    HIF1A (Hypoxia inducible factor 1, alpha subunit) • HK2 (Hexokinase 2) • PKM (Pyruvate Kinase M1/2)
    |
    everolimus • Zydelig (idelalisib) • MK-2206
    9ms
    Serial Measurements of Molecular and Architectural Responses to Therapy (SMMART) PRIME Trial (clinicaltrials.gov)
    P1, N=2, Terminated, OHSU Knight Cancer Institute | Active, not recruiting --> Terminated; Low accrual
    Trial termination
    |
    Keytruda (pembrolizumab) • Opdivo (nivolumab) • Avastin (bevacizumab) • Venclexta (venetoclax) • Lynparza (olaparib) • Mekinist (trametinib) • erlotinib • Gilotrif (afatinib) • Yervoy (ipilimumab) • Ibrance (palbociclib) • dasatinib • Zelboraf (vemurafenib) • Tafinlar (dabrafenib) • carboplatin • Imfinzi (durvalumab) • sorafenib • Rozlytrek (entrectinib) • imatinib • sunitinib • everolimus • Nerlynx (neratinib) • Iclusig (ponatinib) • Kadcyla (ado-trastuzumab emtansine) • Cotellic (cobimetinib) • Lorbrena (lorlatinib) • Lenvima (lenvatinib) • bortezomib • doxorubicin hydrochloride • capecitabine • Verzenio (abemaciclib) • Xtandi (enzalutamide capsule) • Cabometyx (cabozantinib tablet) • albumin-bound paclitaxel • Stivarga (regorafenib) • abiraterone acetate • oxaliplatin • Aliqopa (copanlisib) • Vizimpro (dacomitinib) • Zydelig (idelalisib) • daunorubicin • Zolinza (vorinostat) • Idhifa (enasidenib) • Farydak (panobinostat) • Erivedge (vismodegib) • Nubeqa (darolutamide) • bicalutamide • leucovorin calcium • cabazitaxel • Vesanoid (tretinoin) • fluorouracil topical
    9ms
    Pembrolizumab + Idelalisib for Lung Cancer Study (clinicaltrials.gov)
    P1/2, N=4, Terminated, Asha Nayak | N=40 --> 4 | Unknown status --> Terminated; The study was terminated due to poor accrual.
    Enrollment change • Trial termination • Checkpoint inhibition
    |
    EGFR (Epidermal growth factor receptor) • ALK (Anaplastic lymphoma kinase)
    |
    EGFR mutation • ALK mutation • ALK translocation
    |
    Keytruda (pembrolizumab) • Zydelig (idelalisib)
    9ms
    PI3Kδ inhibition alleviates the brain injury during cerebral ischemia reperfusion via suppressing pericyte contraction in a TNF-α dependent manner. (PubMed, Exp Neurol)
    CAL-101 suppressed the TNF-α-induced TRPV2 expression in OGD/R-treated PCs, thus inhibiting the Ca2+ uptake and PC contraction. Collectively, this study suggests that PI3Kδ is a critical regulator of PC function during ischemic stroke.
    Journal
    |
    TNFA (Tumor Necrosis Factor-Alpha) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • TRPV2 (Transient Receptor Potential Cation Channel Subfamily V Member 2)
    |
    Zydelig (idelalisib)
    9ms
    Design, synthesis, molecular docking, and in vitro studies of 2-mercaptoquinazolin-4(3H)-ones as potential anti-breast cancer agents. (PubMed, Saudi Pharm J)
    This study investigated the potential anticancer activity of some novel quinazolinone derivatives that were designed on the structural framework of two approved anticancer drugs, Ispinesib (KSP inhibitor) and Idelalisib (PI3Kδ inhibitor), to find out solutions for TNBC. The relative gene expression of pro-apoptotic and anti-apoptotic genes revealed an overexpression of the P53 and BAX genes and a downregulation of the BCL-2 gene by real-time PCR. So, this work proved that compounds 3a, 3b, and 3e could be developed as anticancer candidates, via their P53-dependent apoptotic activity.
    Preclinical • Journal • IO biomarker
    |
    HER-2 (Human epidermal growth factor receptor 2) • ER (Estrogen receptor) • TP53 (Tumor protein P53) • PGR (Progesterone receptor) • BCL2 (B-cell CLL/lymphoma 2) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • BAX (BCL2-associated X protein) • ANXA5 (Annexin A5)
    |
    HER-2 expression • BAX expression
    |
    Zydelig (idelalisib) • ispinesib (SB-715992)
    10ms
    Integrating cfDNA liquid biopsy and organoid-based drug screening reveals PI3K signaling as a promising therapeutic target in colorectal cancer. (PubMed, J Transl Med)
    Liquid biopsy holds significant promise for improving precision treatment and tumor prognosis in colorectal cancer patients. The combination of biomarker-based drug prediction with organoid-based functional drug sensitivity assay may lead to more effective cancer treatment.
    Preclinical • Journal • Liquid biopsy • Biopsy
    |
    KRAS (KRAS proto-oncogene GTPase) • BRAF (B-raf proto-oncogene) • TP53 (Tumor protein P53) • PIK3CA (Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) • SMAD4 (SMAD family member 4) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
    |
    TP53 mutation • KRAS mutation • BRAF mutation • PIK3CA mutation • SMAD4 mutation
    |
    everolimus • Piqray (alpelisib) • Zydelig (idelalisib)
    10ms
    β1 integrin mediates unresponsiveness to PI3Kα inhibition for radiochemosensitization of 3D HNSCC models. (PubMed, Biomed Pharmacother)
    Here, we investigated the radiochemosensitizing potential and adaptation mechanisms of four PI3K inhibitors, Alpelisib, Copanlisib, AZD8186, and Idelalisib in eight HNSCC models grown under physiological, three-dimensional matrix conditions. Finally, we demonstrate that targeting of the cell adhesion molecule β1 integrin on top of Alpelisib sensitizes non-responders to radiochemotherapy. Taken together, our study demonstrates the sensitizing potential of Alpelisib and other PI3K inhibitors in HNSCC models and uncovers a novel β1 integrin-dependent mechanism that may prove useful in overcoming resistance to PI3K inhibitors.
    Journal
    |
    PIK3CA (Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha)
    |
    PIK3CA mutation
    |
    Piqray (alpelisib) • Aliqopa (copanlisib) • Zydelig (idelalisib) • AZD8186
    10ms
    A Study to Compare the Efficacy and Safety of Lisocabtagene Maraleucel vs Investigator's Choice Options in Adult Participants With Relapsed or Refractory Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma, Whose Disease Has Failed Treatment With Both BTKi and BCL2i Therapies (clinicaltrials.gov)
    P3, N=200, Not yet recruiting, Juno Therapeutics, Inc., a Bristol-Myers Squibb Company
    New P3 trial
    |
    Rituxan (rituximab) • cyclophosphamide • Zydelig (idelalisib) • Breyanzi (lisocabtagene maraleucel) • bendamustine • fludarabine IV • Belrapzo (bendamustine RTD)
    11ms
    PI3Kδ Inhibition Potentiates Glucocorticoids in B-lymphoblastic Leukemia by Decreasing Receptor Phosphorylation and Enhancing Gene Regulation. (PubMed, Cancers (Basel))
    This mechanism and the response of patient specimens suggest that idelalisib will benefit most patients with B-ALL, but particularly patients with less responsive, including high-risk, disease. This combination is also promising for the development of less toxic glucocorticoid-sparing therapies.
    Journal
    |
    PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • MAPK1 (Mitogen-activated protein kinase 1)
    |
    Zydelig (idelalisib)
    11ms
    Dose Escalation and Dose Expansion Study of Tirabrutinib in Combination With Other Targeted Anti-cancer Therapies in Adults With B-cell Malignancies (clinicaltrials.gov)
    P1, N=203, Active, not recruiting, Gilead Sciences | Phase classification: P1b --> P1
    Phase classification
    |
    Gazyva (obinutuzumab) • Zydelig (idelalisib) • entospletinib (GS-9973) • Velexbru (tirabrutinib)
    12ms
    ERBB4-Mediated Signaling Is a Mediator of Resistance to PI3K and BTK Inhibitors in B-cell Lymphoid Neoplasms. (PubMed, Mol Cancer Ther)
    We started from a marginal zone lymphoma cell line, Karpas-1718, kept under prolonged exposure to the PI3Kδ inhibitor idelalisib until acquisition of resistance, or with no drug...Combination with the ERBB inhibitor lapatinib was beneficial in resistant cells and in other lymphoma models already expressing the identified resistance factors...Resistance factors were also shown to be expressed in clinical specimens. In conclusion, we showed that the overexpression of ERBB4 and its ligands represents a novel mechanism of resistance for lymphoma cells to bypass the antitumor activity of BTK and PI3K inhibitors and that targeted pharmacologic interventions can restore sensitivity to the small molecules.
    Journal
    |
    ERBB4 (erb-b2 receptor tyrosine kinase 4) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • NRG2 (Neuregulin 2)
    |
    lapatinib • Zydelig (idelalisib)
    12ms
    Defining the Drivers of Idelalisib-Related Early Autoimmune Toxicity in Chronic Lymphocytic Leukemia (ASH 2023)
    PI3K inhibitors such as idelalisib and duvelisib have shown promising efficacy in CLL patients, but severe toxicities remain a significant hurdle to their implementation in the clinic (PMID: 24615777). In the non-toxicity group, more diversity of Tregs was identified with depletion of some clusters but also an increase in a cluster. At present, we are integrating the scRNA & scTCR-seq data to characterize the cellular diversity and heterogeneous phenotypic states of the T-cell populations and updated results unraveling molecular mechanisms that drive early severe toxicity in CLL patients with idelalisib treatment will be presented at the meeting.
    IO biomarker
    |
    CD8 (cluster of differentiation 8) • CD4 (CD4 Molecule)
    |
    Zydelig (idelalisib) • Copiktra (duvelisib)
    12ms
    A Systematic Literature Review (SLR) and Meta-Analysis of Clinical Evidence of Second Line or Later (2L+) Treatments for Follicular Lymphoma (FL) in Adult Patients (ASH 2023)
    Eligible treatments included CAR T cell therapies (axicabtagene ciloleucel, lisocabtagene maraleucel, and tisagenlecleucel), T cell engagers (mosunetuzumab, glofitamab, epcoritamab, odronextamab), phosphatidylinositol 3-kinase (PI3K) inhibitors (copanlisib, duvelisib, idelalisib), HSCT, yttrium-90 (90Y) ibritumomab tiuxetan, tazemetostat, and conventional therapies (immunochemotherapies, single- or multiagent chemo- or immunotherapies, and alkylating agents). This SLR demonstrated an evolving FL treatment landscape, with new agents such as CAR T cell therapies and T cell engagers exhibiting potential for improving effectiveness of treatment for patients in 3L+, 4L+, and 2L+ POD24 populations.
    Retrospective data • Review
    |
    Aliqopa (copanlisib) • Zydelig (idelalisib) • Copiktra (duvelisib) • Yescarta (axicabtagene ciloleucel) • Breyanzi (lisocabtagene maraleucel) • Tazverik (tazemetostat) • Kymriah (tisagenlecleucel-T) • Epkinly (epcoritamab-bysp) • Zevalin (ibritumomab tiuxetan) • Lunsumio (mosunetuzumab-axgb) • Columvi (glofitamab-gxbm) • Ordspono (odronextamab)
    12ms
    Comparative Transcriptome Analyses in Mantle Cell Lymphoma (MCL): Evidence of E2F1 As a Major Target in Aggressive Blastoid MCL Model (ASH 2023)
    The mainstay of MCL therapies remains the chemo-immunotherapy followed by autologous transplantation but recently several novel therapies have been developed such as BTK inhibitors, Venetoclax, CDK4/6 inhibitors and more recently CAR-T therapies...Finally, the expression of PIK3CD which encodes for a therapeutic target in MCL (such as PI3KDelta inhibitor Idelalisib) was also significantly repressed in UPN-1 as compared to nine other MCL cell lines...This cell line exhibited a major upregulation of E2F1 expression and a down regulation of the cell cycle inhibitor CDKN1A(p21). The potential effects of the direct inhibition of E2F1 using the targeted inhibitor MTA demonstrated a reduction in cell proliferation and induction of apoptosis, suggesting the possibility of associating clinically acceptable E2F1 inhibition strategies to other current therapies.
    BRCA Biomarker • IO biomarker
    |
    TP53 (Tumor protein P53) • BRCA1 (Breast cancer 1, early onset) • BCL2 (B-cell CLL/lymphoma 2) • CCND1 (Cyclin D1) • RAD51 (RAD51 Homolog A) • CDK2 (Cyclin-dependent kinase 2) • CCNB2 (Cyclin B2) • CDKN1A (Cyclin-dependent kinase inhibitor 1A) • NFKBIA (NFKB Inhibitor Alpha 2) • E2F1 (E2F transcription factor 1)
    |
    TP53 mutation • PIK3CD expression • NFKB1 expression
    |
    Venclexta (venetoclax) • Zydelig (idelalisib)
    1year
    An Updated Comparison of Clinical Outcomes from 4-Year Follow-up of Zuma-5 (Axicabtagene Ciloleucel) and the International Scholar-5 External Control Cohort in Relapsed/Refractory Follicular Lymphoma (ASH 2023)
    In addition, patients initiating therapy after receiving idelalisib in the pivotal DELTA trial were included. These results demonstrate that axi-cel continues to show superior efficacy for R/R FL compared to other available therapies. The response to axi-cel is durable, and offers a clinically meaningful and significant benefit in PFS, TTNT, and OS. These longer follow-up results are particularly important in this indolent disease, where survival outcomes take time to reach maturity.
    Clinical • Clinical data
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    Zydelig (idelalisib) • Yescarta (axicabtagene ciloleucel)
    1year
    Deep Immune Profiling Identifies Novel T-Cell Subpopulations That Influence Specific Clinical Outcomes in Chronic Lymphocytic Leukaemia (CLL) (ASH 2023)
    The discovery cohort comprised pre-treatment samples from 79 CLL patients enrolled in the NCRI RIAltO trial (NCT01678430) who underwent factorial randomisation to ofatumumab and either bendamustine or chlorambucil, with or without idelalisib. The present study has identified three previously undescribed T-cell subpopulations that appear to influence the risk of infection, SPM, and death in patients with CLL receiving frontline chemo-immunotherapy. Further studies are warranted to validate these findings in the setting of targeted agents and in patients receiving CIT for other haematological malignancies.
    Clinical • Clinical data • PD(L)-1 Biomarker • IO biomarker
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    CD8 (cluster of differentiation 8) • PD-1 (Programmed cell death 1) • TIGIT (T Cell Immunoreceptor With Ig And ITIM Domains 2) • CD4 (CD4 Molecule) • ICOS (Inducible T Cell Costimulator) • CD27 (CD27 Molecule)
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    Zydelig (idelalisib) • bendamustine • Arzerra (ofatumumab) • Leukeran (chlorambucil)
    1year
    Novel Pi3kδ Inhibitor Roginolisib Synergizes with the Bcl-2 Inhibitor Venetoclax in Hematological Malignancies (ASH 2023)
    To further validate this finding, the combination of roginolisib with venetoclax or with another bcl-2 inhibitor S55746 was tested in a broad range of lymphoma cell lines including GRANTA519, JVM2, SP49 (MCL); FARAGE, TMD8 (diffuse large B cell lymphoma); MEC1 (chronic lymphocytic leukemia); MJ (cutaneous T cell lymphoma); and YT (NK lymphoma)...Other BCRi such as idelalisib, duvelisib and acalabrutinib were used at 5 μM concentrations as positive controls...In addition, roginolisib synergized with venetoclax in lymphoma cell lines and CLL patient samples. Our data support extending this combination strategy to clinical trials in hematological malignancies.
    IO biomarker
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    MCL1 (Myeloid cell leukemia 1) • BCL2L1 (BCL2-like 1) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
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    BCL2 expression • PIK3CD expression
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    Venclexta (venetoclax) • Calquence (acalabrutinib) • Zydelig (idelalisib) • Copiktra (duvelisib) • S55746 • roginolisib (IOA-244)
    1year
    Combination of CDK4/6 Inhibitor Palbociclib and PI3K Inhibitor Idelalisib Synergistically Induces an Anti-Tumor Effect in B-Cell Lymphoma and Overcomes Ibrutinib Resistance (ASH 2023)
    The combination of CDK4/6 inhibitor palbociclib and PI3K inhibitor idelalisib synergistically induced anti-tumor activity in B-cell lymphoma through downregulation of PLK1 expression, suggested a new combination direction for the treatment of B-NHL and even BTK inhibitor-resistant patients.
    PARP Biomarker • IO biomarker
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    BCL2 (B-cell CLL/lymphoma 2) • CDKN2A (Cyclin Dependent Kinase Inhibitor 2A) • CCND1 (Cyclin D1) • MCL1 (Myeloid cell leukemia 1) • BCL2L1 (BCL2-like 1) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • PLK1 (Polo Like Kinase 1) • CASP3 (Caspase 3) • XIAP (X-Linked Inhibitor Of Apoptosis)
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    BCL2 expression • BTK C481S • MCL1 expression • CCND1 expression • CCND1 expression + CDK4 expression • CDK6 expression
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    Ibrance (palbociclib) • Imbruvica (ibrutinib) • Zydelig (idelalisib)
    1year
    High Dimensional Detection of Non-Malignant B-Cells and Its Clinical Implications in Patients with Chronic Lymphocytic Leukaemia (CLL) Undergoing Frontline Therapy (ASH 2023)
    Patients were randomly assigned to receive bendamustine or chlorambucil plus ofatumumab, with or without idelalisib. To our knowledge, this is the first study to identify correlations between the re-emergence of non-malignant B-cells following anti-CLL therapy and specific clinical endpoints such as haematopoietic recovery, serum Ig levels, TTP and OS. Although further validation is required in the context of targeted agents, our findings suggest that therapy-induced re-emergence of non-malignancy B-cells may have important biological and clinical implications in CLL.
    Clinical • IO biomarker
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    CD20 (Membrane Spanning 4-Domains A1) • CD79B (CD79b Molecule) • ROR1 (Receptor Tyrosine Kinase Like Orphan Receptor 1) • CD5 (CD5 Molecule) • CD27 (CD27 Molecule) • SPN (Sialophorin) • CD81 (CD81 Molecule)
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    Zydelig (idelalisib) • bendamustine • Arzerra (ofatumumab) • Leukeran (chlorambucil)
    1year
    Immunomodulatory Effects of Chemo-Immunotherapy ± Idelalisib in Chronic Lymphocytic Leukaemia (CLL) (ASH 2023)
    Patients were randomly assigned to receive ofatumumab plus either bendamustine or chlorambucil, with or without idelalisib. CIT results in profound immune changes that persists up to 18.5 [16.1 – 22.6] months following treatment. Furthermore, the overall effect of these changes further differentiates the CLL-associated immune profile from that of HC, deepening the existing T-cell dysfunction irrespective of chemotherapy choice, or the addition of idelalisib. Our study has important potential implications for patients receiving CIT in a range of clinical settings and supports the move towards more targeted agents that are less likely to cause indiscriminate immune perturbation.
    PD(L)-1 Biomarker • IO biomarker • Immunomodulating
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    PD-1 (Programmed cell death 1) • TIGIT (T Cell Immunoreceptor With Ig And ITIM Domains 2) • PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta)
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    PD-1 expression
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    Zydelig (idelalisib) • bendamustine • Arzerra (ofatumumab) • Leukeran (chlorambucil)
    1year
    Addition of Inotuzumab Ozogamicin to the Conditioning Regimen of Allogeneic Stem Cell Transplantation (allo-SCT) for Relapsed CD22 (+) Lymphoid Malignancies: Long-Term Survival Results (ASH 2023)
    In order to improve outcomes in patients with relapsed CD22 (+) NHL, or chronic lymphocytic leukemia (CLL) who failed targeted therapies and were candidates for allo-SCT, we prospectively studied the addition of InO to our standard chemo-conditioning of BFR (bendamustine, fludarabine and rituximab-Khouri Blood 2014)...Tacrolimus and mini-methotrexate were used for graft versus host disease (GVHD) prophylaxis...Patients with CLL/MCL were previously treated with ibritunib (n=10), venetoclax (n=5), idelalisib (n=2), nivolumab (n=1) and CAR T (n=1)... Our results show that InO is safe when combined with an allo-SCT conditioning regimen and may improve survival outcomes in patients with CD22 (+) NHL. This needs to be validated in a larger number of patients. An ongoing trial at our center involves fractionating InO dose pre-and post-allo-SCT in patients with lymphoma or acute lymphoblastic leukemia receiving a reduced-intensity conditioning, and adding post-transplant cyclophosphamide to decrease the risk of GVHD.
    PD(L)-1 Biomarker
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    TP53 (Tumor protein P53) • IGH (Immunoglobulin Heavy Locus) • CD22 (CD22 Molecule) • CDH2 (Cadherin 2) • ZMYM3 (Zinc Finger MYM-Type Containing 3)
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    TP53 mutation • CD22 expression
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    Opdivo (nivolumab) • Venclexta (venetoclax) • Rituxan (rituximab) • cyclophosphamide • methotrexate • Zydelig (idelalisib) • Besponsa (inotuzumab ozogamicin) • bendamustine • fludarabine IV