What is the role of Phosphatidylinositol 3-kinase (PI3K) in follicular development?

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Last updated: May 21, 2025View editorial policy

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From the Research

PI3K inhibitors, such as idelalisib, are a valuable treatment option for patients with relapsed or refractory follicular lymphoma, with overall response rates of 40-60% in heavily pretreated patients, as shown in a study published in 2020 1.

Key Points

  • PI3K inhibitors target the phosphatidylinositol 3-kinase pathway, which is crucial for B-cell receptor signaling and lymphoma cell survival.
  • Idelalisib is typically dosed at 150 mg twice daily, and common side effects include diarrhea, colitis, pneumonitis, hepatotoxicity, and opportunistic infections.
  • Regular monitoring of liver function tests, blood counts, and signs of infection is essential during treatment.
  • A study published in 2020 found that idelalisib is safe and remains an option in higher line therapy after the failure of other novel agents and/or chemoimmunotherapy, with careful monitoring and prophylaxis usage 2.

Treatment Considerations

  • PI3K inhibitors have shown significant efficacy in patients with relapsed or refractory follicular lymphoma, with overall response rates of 40-60% in heavily pretreated patients.
  • Idelalisib has been shown to be effective in combination with rituximab for the treatment of relapsed chronic lymphocytic leukemia (CLL) and relapsed follicular lymphoma, with significant improvements in progression-free survival and overall survival 3.
  • The development of new PI3K inhibitors with improved tolerability and sustained efficacy is ongoing, and these agents may offer new treatment options for patients with follicular lymphoma in the future 1.

Monitoring and Safety

  • Regular monitoring of liver function tests, blood counts, and signs of infection is essential during treatment with PI3K inhibitors.
  • Patients should be closely monitored for signs of diarrhea, colitis, pneumonitis, hepatotoxicity, and opportunistic infections, and prophylactic measures should be taken to prevent these adverse events.
  • The use of PI3K inhibitors in combination with other agents may increase the risk of adverse events, and patients should be closely monitored for signs of toxicity 4.

References

Research

Idelalisib- a PI3Kδ targeting agent for B-cell malignancies.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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