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度维利塞,一种口服双重 PI3K-δ、γ抑制剂,在一项 1 期研究中,在慢性淋巴细胞白血病和小淋巴细胞淋巴瘤中显示出临床和药效学活性。

Duvelisib, an oral dual PI3K-δ,γ inhibitor, shows clinical and pharmacodynamic activity in chronic lymphocytic leukemia and small lymphocytic lymphoma in a phase 1 study.

机构信息

MD Anderson Cancer Center, Houston, Texas.

Florida Cancer Specialists, Sarasota, Florida.

出版信息

Am J Hematol. 2018 Nov;93(11):1318-1326. doi: 10.1002/ajh.25243. Epub 2018 Oct 20.

Abstract

Duvelisib (IPI-145), an oral, dual inhibitor of phosphoinositide-3-kinase (PI3K)-δ and -γ, was evaluated in a Phase 1 study in advanced hematologic malignancies, which included expansion cohorts in relapsed/refractory (RR) chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and treatment-naïve (TN) CLL. Per protocol, TN patients were at least 65 years old or had a del(17p)/TP53 mutation. Duvelisib was administered twice daily (BID) in 28-day cycles at doses of 8-75 mg in RR patients (n = 55) and 25 mg in TN patients (n = 18.) Diarrhea was the most common nonhematologic AE (TN 78%, RR 47%); transaminase elevations the most frequent lab-abnormality AE (TN 33.3%, RR 30.9%); and neutropenia the most common ≥grade 3 AE (RR 44%, TN 33%). The overall response rates were 56.4% for RR patients (1.8% CR, 54.5% PR) and 83.3% for TN patients (all PRs); median response duration was 21.0 months in RR patients but was not reached for TN patients. Based upon phase 1 efficacy, pharmacodynamics, and safety, duvelisib 25 mg BID was selected for further investigation in a phase 3 study in RR CLL/SLL.

摘要

杜韦利昔布(IPI-145)是一种口服、双重磷酸肌醇 3-激酶(PI3K)-δ 和 -γ抑制剂,在晚期血液恶性肿瘤的 1 期研究中进行了评估,该研究包括复发/难治性(RR)慢性淋巴细胞白血病(CLL)/小淋巴细胞淋巴瘤(SLL)和初治(TN)CLL 的扩展队列。根据方案,TN 患者年龄至少为 65 岁或存在 del(17p)/TP53 突变。RR 患者接受 8-75mg 剂量的杜韦利昔布每日两次(BID)给药,28 天为一个周期(n=55),TN 患者接受 25mg 剂量的杜韦利昔布(n=18)。腹泻是最常见的非血液学不良事件(TN 为 78%,RR 为 47%);转氨酶升高是最常见的实验室异常不良事件(TN 为 33.3%,RR 为 30.9%);中性粒细胞减少是最常见的≥3 级不良事件(RR 为 44%,TN 为 33%)。RR 患者的总缓解率为 56.4%(1.8%CR,54.5%PR),TN 患者为 83.3%(均为 PR);RR 患者的中位缓解持续时间为 21.0 个月,但 TN 患者未达到。基于 1 期疗效、药效学和安全性,选择杜韦利昔布 25mg BID 用于 RR CLL/SLL 的 3 期研究。

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