Incidence and management of toxicity associated with ibrutinib and idelalisib: a practical approach

The use of novel B-cell receptor signaling inhibitors results in high response rates and long progression-free survival in patients with indolent B-cell malignancies, such as chronic lymphocytic leukemia, follicular lymphoma, mantle cell lymphoma and Waldenström macroglobulinemia. Ibrutinib, the fir...

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Bibliographic Details
Published in:Haematologica (Roma) Vol. 102; no. 10; pp. 1629 - 1639
Main Authors: de Weerdt, Iris, Koopmans, Suzanne M., Kater, Arnon P., van Gelder, Michel
Format: Journal Article
Language:English
Published: Italy Ferrata Storti Foundation 01.10.2017
Subjects:
Agammaglobulinaemia Tyrosine Kinase
Antineoplastic Agents - adverse effects
Disease Management
Drug Interactions
Drug-Related Side Effects and Adverse Reactions - diagnosis
Drug-Related Side Effects and Adverse Reactions - epidemiology
Drug-Related Side Effects and Adverse Reactions - etiology
Drug-Related Side Effects and Adverse Reactions - therapy
Humans
Incidence
Leukemia, Lymphocytic, Chronic, B-Cell - complications
Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - drug therapy
Protein Kinase Inhibitors - adverse effects
Protein-Tyrosine Kinases - antagonists & inhibitors
Purines - administration & dosage
Purines - adverse effects
Pyrazoles - administration & dosage
Pyrazoles - adverse effects
Pyrimidines - administration & dosage
Pyrimidines - adverse effects
Quinazolinones - administration & dosage
Quinazolinones - adverse effects
Review
Severity of Illness Index
ISSN:0390-6078, 1592-8721, 1592-8721
Online Access:Get full text
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Description
Summary:The use of novel B-cell receptor signaling inhibitors results in high response rates and long progression-free survival in patients with indolent B-cell malignancies, such as chronic lymphocytic leukemia, follicular lymphoma, mantle cell lymphoma and Waldenström macroglobulinemia. Ibrutinib, the first-in-class inhibitor of Bruton tyrosine kinase, and idelalisib, the first-in-class inhibitor of phosphatidylinositol 3-kinase , have recently been approved for the treatment of several indolent B-cell malignancies. These drugs are especially being used for previously unmet needs, i.e., for patients with relapsed or refractory disease, high-risk cytogenetic or molecular abnormalities, or with comorbidities. Treatment with ibrutinib and idelalisib is generally well tolerated, even by elderly patients. However, the use of these drugs may come with toxicities that are distinct from the side effects of immunochemotherapy. In this review we discuss the most commonly reported and/or most clinically relevant adverse events associated with these B-cell receptor inhibitors, with special emphasis on recommendations for their management.
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ISSN:0390-6078
1592-8721
1592-8721
DOI:10.3324/haematol.2017.164103