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

2018; Taylor & Francis; Volume: 30; Issue: 5 Linguagem: Inglês

10.1080/1120009x.2018.1516184

1973-9478

Caroline Migault, Delphine Lebrun, O Toubas, Yohan N’Guyen, Aurélien Giltat, Julien Gautier, D. Toubas, François Lebargy, Alain Delmer, Firouzé Bani‐Sadr,

Lymphoma Diagnosis and Treatment

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.