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Published in: Drugs 14/2014

01-09-2014 | R&D Insight Report

Idelalisib: First Global Approval

Author: Anthony Markham

Published in: Drugs | Issue 14/2014

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Abstract

Idelalisib (Zydelig®) is a highly specific small-molecule phosphatidylinositol-3-kinase (PI3Kδ) inhibitor that has been developed as an oral treatment for B cell haematological cancers. It has received its first approval in the US in July 2014 for the treatment of relapsed chronic lymphocytic leukaemia (CLL), relapsed follicular B-cell non-Hodgkin lymphoma (NHL) and relapsed small lymphocytic leukaemia (SLL). Idelalisib is under regulatory review in the EU—where it has received a positive opinion from the European Medicines Agency Committee for Medicinal Products for Human Use—and in clinical development for CLL in Australia and Canada. This article summarizes the milestones in the development of Idelalisib leading to this first approval for relapsed CLL, NHL and SLL.
Literature
1.
2.
go back to reference Herman SE, Gordon AL, Wagner AJ, et al. Phosphatidylinositol 3-kinase-delta inhibitor CAL-101 shows promising preclinical activity in chronic lymphocytic leukemia by antagonizing intrinsic and extrinsic cellular survival signals. Blood. 2010;116(12):2078–88.PubMedCrossRefPubMedCentral Herman SE, Gordon AL, Wagner AJ, et al. Phosphatidylinositol 3-kinase-delta inhibitor CAL-101 shows promising preclinical activity in chronic lymphocytic leukemia by antagonizing intrinsic and extrinsic cellular survival signals. Blood. 2010;116(12):2078–88.PubMedCrossRefPubMedCentral
10.
go back to reference Meadows SA, Vega F, Kashishian A, et al. PI3Kdelta inhibitor, GS-1101 (CAL-101), attenuates pathway signaling, induces apoptosis, and overcomes signals from the microenvironment in cellular models of Hodgkin lymphoma. Blood. 2012;119(8):1897–900.PubMedCrossRef Meadows SA, Vega F, Kashishian A, et al. PI3Kdelta inhibitor, GS-1101 (CAL-101), attenuates pathway signaling, induces apoptosis, and overcomes signals from the microenvironment in cellular models of Hodgkin lymphoma. Blood. 2012;119(8):1897–900.PubMedCrossRef
11.
go back to reference Flinn IW, Kahl BS, Leonard JP, et al. Idelalisib, a selective inhibitor of phosphatidylinositol 3-kinase-delta, as therapy for previously treated indolent non-Hodgkin lymphoma. Blood. 2014;123(22):3406–13.PubMedCrossRef Flinn IW, Kahl BS, Leonard JP, et al. Idelalisib, a selective inhibitor of phosphatidylinositol 3-kinase-delta, as therapy for previously treated indolent non-Hodgkin lymphoma. Blood. 2014;123(22):3406–13.PubMedCrossRef
12.
go back to reference Brown JR, Byrd JC, Coutre SE, et al. Idelalisib, an inhibitor of phosphatidylinositol 3-kinase p110, for relapsed/refractory chronic lymphocytic leukemia. Blood. 2014;123(22):3390–7.PubMedCrossRef Brown JR, Byrd JC, Coutre SE, et al. Idelalisib, an inhibitor of phosphatidylinositol 3-kinase p110, for relapsed/refractory chronic lymphocytic leukemia. Blood. 2014;123(22):3390–7.PubMedCrossRef
13.
go back to reference Kahl BS, Spurgeon SE, Furman RR, et al. A phase 1 study of the PI3Kd inhibitor idelalisib in patients with relapsed/refractory mantle cell lymphoma (MCL). Blood. 2014;123(22):3398–405.PubMedCrossRef Kahl BS, Spurgeon SE, Furman RR, et al. A phase 1 study of the PI3Kd inhibitor idelalisib in patients with relapsed/refractory mantle cell lymphoma (MCL). Blood. 2014;123(22):3398–405.PubMedCrossRef
14.
go back to reference Jin F, Robeson M, Zhou H, et al. Pharmacokinetics and safety of idelalisib, a novel PI3K inhibitor, in Japanese and caucasian subjects [abstract no. 5575]. Blood. 2013;122(21). Jin F, Robeson M, Zhou H, et al. Pharmacokinetics and safety of idelalisib, a novel PI3K inhibitor, in Japanese and caucasian subjects [abstract no. 5575]. Blood. 2013;122(21).
15.
go back to reference Jin F, Robeson M, Zhou H, et al. Pharmacokinetics, metabolism and excretion of idelalisib. In: 55th Annual Meeting of the American Society of Hematology, ASH; 10–13 August 2013; New Orleans, LA. Jin F, Robeson M, Zhou H, et al. Pharmacokinetics, metabolism and excretion of idelalisib. In: 55th Annual Meeting of the American Society of Hematology, ASH; 10–13 August 2013; New Orleans, LA.
16.
go back to reference Jin F, Robeson M, Zhou H, et al. Evaluation of the effect of idelalisib on the QT/QTC interval in healthy subjects [abstract no. 5573]. Blood. 2013;122(21). Jin F, Robeson M, Zhou H, et al. Evaluation of the effect of idelalisib on the QT/QTC interval in healthy subjects [abstract no. 5573]. Blood. 2013;122(21).
17.
go back to reference Jin F, Robeson M, Zhou H, et al. The pharmacokinetics and safety of idelalisib in subjects with severe renal impairment [abstract no. 5572]. Blood. 2013;122(21). Jin F, Robeson M, Zhou H, et al. The pharmacokinetics and safety of idelalisib in subjects with severe renal impairment [abstract no. 5572]. Blood. 2013;122(21).
18.
go back to reference Jin F, Robeson M, Zhou H, et al. The pharmacokinetics and safety of idelalisib in subjects with moderate or severe hepatic impairment. In: 55th Annual Meeting of the American Society of Hematology, ASH; 2013; New Orleans, LA. Jin F, Robeson M, Zhou H, et al. The pharmacokinetics and safety of idelalisib in subjects with moderate or severe hepatic impairment. In: 55th Annual Meeting of the American Society of Hematology, ASH; 2013; New Orleans, LA.
19.
go back to reference Jin F, Robeson M, Zhou H, et al. The pharmacokinetics and safety of idelalisib in subjects with moderate or severe hepatic impairment [abstract no. 2592]. J Clin Oncol. (Meeting Abstracts). 2014;32(15 suppl. 1). Jin F, Robeson M, Zhou H, et al. The pharmacokinetics and safety of idelalisib in subjects with moderate or severe hepatic impairment [abstract no. 2592]. J Clin Oncol. (Meeting Abstracts). 2014;32(15 suppl. 1).
20.
go back to reference Jin F, Robeson M, Zhou H, et al. Drug interaction profile of idelalisib and its major metabolite, GS-563117 [abstract no. 2593]. J Clin Oncol. (Meeting Abstracts). 2014;32(15 suppl. 1). Jin F, Robeson M, Zhou H, et al. Drug interaction profile of idelalisib and its major metabolite, GS-563117 [abstract no. 2593]. J Clin Oncol. (Meeting Abstracts). 2014;32(15 suppl. 1).
21.
22.
go back to reference Furman RR, De Vos S, Leonard JP, et al. A Phase 1 Study Of The Selective PI3Kdelta Inhibitor Idelalisib (GS-1101) In Combination With Therapeutic Anti-CD20 Antibodies (Rituximab or Ofatumumab) In Patients With Relapsed Or Refractory Chronic Lymphocytic Leukemia [abstr. 4180]. In: 55th Annual Meeting and Exposition of the American Society of Hematology; 7–10 December 2013; New Orleans, LA. Furman RR, De Vos S, Leonard JP, et al. A Phase 1 Study Of The Selective PI3Kdelta Inhibitor Idelalisib (GS-1101) In Combination With Therapeutic Anti-CD20 Antibodies (Rituximab or Ofatumumab) In Patients With Relapsed Or Refractory Chronic Lymphocytic Leukemia [abstr. 4180]. In: 55th Annual Meeting and Exposition of the American Society of Hematology; 7–10 December 2013; New Orleans, LA.
23.
go back to reference Barrientos JC, Wagner-Johnston ND, De Vos S, et al. Chemo-immunotherapy combination of idelalisib with bendamustine/rituximab or chlorambucil/rituximab in patients with relapsed/refractory CLL demonstrates efficacy and tolerability. In: 55th Annual Meeting of the American Society of Hematology, ASH; 7–10 December 2013; New Orleans, LA. Barrientos JC, Wagner-Johnston ND, De Vos S, et al. Chemo-immunotherapy combination of idelalisib with bendamustine/rituximab or chlorambucil/rituximab in patients with relapsed/refractory CLL demonstrates efficacy and tolerability. In: 55th Annual Meeting of the American Society of Hematology, ASH; 7–10 December 2013; New Orleans, LA.
24.
go back to reference De Vos S, Furman RR, Barrientos JC, et al. Idelalisib, a Selective Inhibitor Of PI3Kδ, In Combination With Bendamustine, Fludarabine Or Chlorambucil In Patients With Relapsed Or Refractory (R/R) Chronic Lymphocytic Leukemia (CLL) [abstr. 2878]. In: 55th Annual Meeting and Exposition of the American Society of Hematology; 7–10 December 2013; New Orleans, LA. De Vos S, Furman RR, Barrientos JC, et al. Idelalisib, a Selective Inhibitor Of PI3Kδ, In Combination With Bendamustine, Fludarabine Or Chlorambucil In Patients With Relapsed Or Refractory (R/R) Chronic Lymphocytic Leukemia (CLL) [abstr. 2878]. In: 55th Annual Meeting and Exposition of the American Society of Hematology; 7–10 December 2013; New Orleans, LA.
25.
go back to reference Coutre SE, Leonard JP, Barrimentos JC, et al. Clinical Activity Of Idelalisib (GS-1101), a Selective Inhibitor Of PI3Kδ, In Phase 1 and 2 Trials In Chronic Lymphocytic Leukemia (CLL): Effect Of Del(17p)/TP53 Mutation, Del(11q), IGHV Mutation, and NOTCH1 Mutation [abstr. 1632]. In: 55th Annual Meeting and Exposition of the American Society of Hematology; 7–10 December 2014; New Orleans, LA. Coutre SE, Leonard JP, Barrimentos JC, et al. Clinical Activity Of Idelalisib (GS-1101), a Selective Inhibitor Of PI3Kδ, In Phase 1 and 2 Trials In Chronic Lymphocytic Leukemia (CLL): Effect Of Del(17p)/TP53 Mutation, Del(11q), IGHV Mutation, and NOTCH1 Mutation [abstr. 1632]. In: 55th Annual Meeting and Exposition of the American Society of Hematology; 7–10 December 2014; New Orleans, LA.
26.
go back to reference O’Brien SM, Lamanna N, Kipps TJ, et al. A phase 2 study of the selective phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor idelalisib (GS-1101) in combination with rituximab in treatment-naive patients ≥65 years with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Conference Presentation. 2013. O’Brien SM, Lamanna N, Kipps TJ, et al. A phase 2 study of the selective phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor idelalisib (GS-1101) in combination with rituximab in treatment-naive patients ≥65 years with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Conference Presentation. 2013.
27.
go back to reference O’Brien SM, Lamanna N, Kipps TJ, et al. A phase II study of the selective phosphatidylinositol 3-kinase delta (PI3K) inhibitor idelalisib (GS-1101) in combination with rituximab (R) in treatment-naive patients (pts) 65 years with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). J Clin Oncol (Meeting Abstracts). 2013;31(15 suppl. 1):7005. O’Brien SM, Lamanna N, Kipps TJ, et al. A phase II study of the selective phosphatidylinositol 3-kinase delta (PI3K) inhibitor idelalisib (GS-1101) in combination with rituximab (R) in treatment-naive patients (pts) 65 years with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). J Clin Oncol (Meeting Abstracts). 2013;31(15 suppl. 1):7005.
28.
go back to reference Wagner-Johnston ND, Gopal AK, Kahl BS, et al. Patient-reported outcomes data from a phase 2 study of idelalisib in patients with refractory indolent B-cell non-Hodgkin lymphoma (iNHL). J Clin Oncol (Meetings Abstracts). 2014;32(15 suppl. 1):e19554. Wagner-Johnston ND, Gopal AK, Kahl BS, et al. Patient-reported outcomes data from a phase 2 study of idelalisib in patients with refractory indolent B-cell non-Hodgkin lymphoma (iNHL). J Clin Oncol (Meetings Abstracts). 2014;32(15 suppl. 1):e19554.
29.
go back to reference Wagner-Johnston ND, De Vos S, Leonard J, et al. Preliminary results of PI3Kδ inhibitor idelalisib (GS-1101) treatment in combination with everolimus, bortezomib, or bendamustine/rituximab in patients with previously treated mantle cell lymphoma (MCL). Conference Presentation. 2013. Wagner-Johnston ND, De Vos S, Leonard J, et al. Preliminary results of PI3Kδ inhibitor idelalisib (GS-1101) treatment in combination with everolimus, bortezomib, or bendamustine/rituximab in patients with previously treated mantle cell lymphoma (MCL). Conference Presentation. 2013.
30.
go back to reference Younes A, Moskowitz A, Moskowitz C, et al. PILOT phase 2 study of idelalisib, a selective inhibitor of PI3Kδ, in patients with heavily pretreated hodgkin lymphoma (HL). Conference presentation. 2013. Younes A, Moskowitz A, Moskowitz C, et al. PILOT phase 2 study of idelalisib, a selective inhibitor of PI3Kδ, in patients with heavily pretreated hodgkin lymphoma (HL). Conference presentation. 2013.
31.
go back to reference Flinn I, Kimby E, Cotter FE, et al. A phase III, randomized, controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with ofatumumab for previously treated chronic lymphocytic leukemia (CLL) [abstract no. TPS7131]. J Clin Oncol. 2013;31(suppl.). Flinn I, Kimby E, Cotter FE, et al. A phase III, randomized, controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with ofatumumab for previously treated chronic lymphocytic leukemia (CLL) [abstract no. TPS7131]. J Clin Oncol. 2013;31(suppl.).
32.
go back to reference Eradat HA, Robak T, Delgado J, et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with bendamustine and rituximab for previously treated chronic lymphocytic leukemia (CLL) [abstract no. TPS7127]. J Clin Oncol. 2014;32(5 suppl.). Eradat HA, Robak T, Delgado J, et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with bendamustine and rituximab for previously treated chronic lymphocytic leukemia (CLL) [abstract no. TPS7127]. J Clin Oncol. 2014;32(5 suppl.).
33.
go back to reference Salles GA, Lamanna N, Amin BR, et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib in combination with bendamustine and rituximab for previously untreated chronic lymphocytic leukemia [abstract no. TPS7123]. J Clin Oncol. 2014;32(5 suppl.). Salles GA, Lamanna N, Amin BR, et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib in combination with bendamustine and rituximab for previously untreated chronic lymphocytic leukemia [abstract no. TPS7123]. J Clin Oncol. 2014;32(5 suppl.).
34.
go back to reference Salles GA, Ervin TJ, Dichmann R, et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib in combination with rituximab for previously treated indolent non-Hodgkin lymphomas (iNHL) [abstract no. TPS8620]. J Clin Oncol. 2014;32(5 suppl.). Salles GA, Ervin TJ, Dichmann R, et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib in combination with rituximab for previously treated indolent non-Hodgkin lymphomas (iNHL) [abstract no. TPS8620]. J Clin Oncol. 2014;32(5 suppl.).
35.
go back to reference de Vos S, Sehn LH, Mulligan SP, et al. A phase III, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with bendamustine and rituximab for previously treated indolent non-Hodgkin lymphomas (iNHL) [abstract no. TPS8618]. J Clin Oncol. 2013;31(suppl.). de Vos S, Sehn LH, Mulligan SP, et al. A phase III, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with bendamustine and rituximab for previously treated indolent non-Hodgkin lymphomas (iNHL) [abstract no. TPS8618]. J Clin Oncol. 2013;31(suppl.).
Metadata
Title
Idelalisib: First Global Approval
Author
Anthony Markham
Publication date
01-09-2014
Publisher
Springer International Publishing
Published in
Drugs / Issue 14/2014
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-014-0285-6

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