Pulmonary adverse events related to idelalisib therapy: A single centre experience.

Fiche publication

Date publication

septembre 2018

Journal

Journal of chemotherapy (Florence, Italy)

Auteurs

Membres identifiés du Cancéropôle Est :
Pr DELMER Alain

Tous les auteurs :
Migault C, Lebrun D, Toubas O, Nguyen Y, Giltat A, Julien G, Toubas D, Lebargy F, Delmer A, Bani-Sadr F

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/30299215

Résumé

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.