Hematologic Oncology Update, Issue 3, 2016 (Video Program) - Video 3Activity of FDA-approved (idelalisib) and investigational (copanlisib) PI3K inhibitors in indolent NHL
2:50 minutes.
TRANSCRIPTION:
DR SEHN: Idelalisib is a novel agent that’s just been recently approved for indolent B-cell lymphomas, relapsed after prior therapy. I think that idelalisib is a very interesting agent. Of course it is the fruition of what I’ve already talked about, that increased biological insight, leading to targeted agents trying to stop the lymphoma based on its underlying mechanisms that are causing it to proliferate. PI3 kinase and, in this case, PI3 kinase delta is a key mediator of some of those pathways in B-cell lymphomas. And certainly data is emerging to show that idelalisib, as an inhibitor of PI3 kinase delta, does have efficacy in a variety of lymphomas. So in the pivotal trial that actually got it approved in patients who were actually very refractory — so refractory to previous alkylators and rituximab — actually showed significant benefit with response rates that were certainly over 60%, or 50% to 60% in many patient subsets. And some of these patients had very durable responses. So it is a drug that’s now approved for use. And I do use it now in my own clinic when patients have failed other options. DR LOVE: So there are other PI3 kinase agents that are in development. One that we’ve seen some data on — we sent you an abstract. We were kind of curious what your thoughts were — copanlisib. What’s the difference between that and idelalisib? What do we know about it in indolent lymphoma, mantle cell, follicular? DR SEHN: Mm-hmm. So what we’re learning is that these targeted agents, by their very nature, are targeting some aspect of the biology of indolent lymphomas. Idelalisib was the first drug and first in class available for management. But it targets PI3 kinase delta isoform. There are a number of isoforms of PI3 kinase that mediate proliferation in indolent lymphomas. And so the other agents that are being developed, some of them are developed in a way where they’re actually targeting a broader class of PI3 kinase. So copanlisib that you mentioned, that actually is known to target PI3 kinase alpha and delta. And by targeting a broader scope of PI3 kinase, it’s thought that it might have an advantage, although that agent is still in development. And we’re looking forward to seeing more clinical data emerging looking at its utility. |