Idelalisib may have the potential to increase radiotherapy side effects
Thomas Gryc1, Florian Putz2, Nicole Goerig2
1Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, D-91054, Erlangen, Germany. thomas.gryc@uk-erlangen.de.
Radiation Oncology (London, England)
|June 30, 2017
Summary
Idelalisib combined with radiation therapy increases radiosensitivity and the risk of severe side effects like radiodermatitis and mucositis. Close patient monitoring is crucial for managing combined Idelalisib and radiotherapy treatments.
Area of Science:
- Oncology
- Pharmacology
- Radiation Oncology
Background:
- Idelalisib is a selective phosphatidylinositol 3-kinase-δ (PI3K-δ) inhibitor used in treating certain B-cell malignancies.
- PI3K-δ plays a critical role in B-cell proliferation, making it a target for cancer therapy.
Observation:
- A case study investigated acute adverse effects of radiation therapy concurrent with Idelalisib medication in a patient with B-cell chronic lymphocytic leukemia (B-CLL).
- Radiosensitivity tests were conducted on the patient's lymphocytes and skin fibroblasts, both in vivo and in vitro, under Idelalisib treatment.
Findings:
- The patient developed severe radiodermatitis (grade 2) and mucositis (grade 3) with combined Idelalisib and 20 Gy irradiation, compared to grade 1 dermatitis without Idelalisib.
- In vitro studies showed Idelalisib increased lymphocyte radiosensitivity and induced apoptosis in skin fibroblasts in a dose-dependent manner.
- A tendency towards increased radiosensitivity was observed when lymphocytes were treated with 2 Gy and 10 nmol/l Idelalisib.
Implications:
- Combined Idelalisib and radiotherapy treatment poses an elevated risk of acute side effects.
- Careful patient selection and close monitoring are essential for the safe and feasible application of combined Idelalisib and radiotherapy.
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