Pulmonary adverse events related to idelalisib therapy: A single centre experience. (4th July 2018)

• Record Type: Journal Article
• Authors: Migault, Caroline; Lebrun, Delphine; Toubas, Olivier; Nguyen, Yohan; Giltat, Aurélien; Julien, Gautier; Toubas, Dominique; Lebargy, François; Delmer, Alain; Bani-Sadr, Firouzé
• Is Part Of: Journal of chemotherapy. Volume 30:Number 5(2018)
• Page Start: 318
• Page End: 322
• Publication Date: 2018-07-04
• Subjects: Idelalisib-related pneumonitis -- idelalisib -- idelalisib-associated pneumonitis; Chemotherapy -- Periodicals; Drug Therapy -- Periodicals; 615.58
• DOI: 10.1080/1120009X.2018.1516184
• Languages: English
• ISSNs: 1120-009X

Abstract

Abstract : Idelalisib is a potent and selective inhibitor of the PI3Kδ approved since September 2014 for the treatment of several types of B cell malignancies. Pulmonary adverse events related to idelalisib are an emerging serious adverse event. We report here a single centre cohort of 16 patients who initiated idelalisib as routine treatment. Five of them experienced severe pulmonary adverse events related to idelalisib therapy. Comparison of the 5 patients with severe pulmonary events versus the 11 patients without identified no predisposing factors. Severe pulmonary adverse events were related to infectious pneumonia and/or to a drug-induced pneumonitis. The mechanisms of idelalisib-associated pneumonitis are unknown but consistent with the drug-induced pneumonitis described with mTOR inhibitors. Indeed, by inhibiting PI3Kδ, idelalisib also inhibits the mTOR pathway. Clinicians should be aware that any idelalisib-treated patient who presents with pulmonary symptoms should be evaluated for pneumonitis. Corticosteroids should be considered in addition to anti-infective therapy in case of severe pneumonitis or persistent pulmonary symptoms despite adequate antibiotic therapy.