Idelalisib: Practical Tools for Identifying and Managing Adverse Events in Clinical Practice

Idelalisib is a first-in-class oral selective inhibitor of phosphatidylinositol 3-kinase delta, which is selectively expressed in hematopoietic cells, where it is critical to B-cell receptor signaling and B-cell development and function. Idelalisib is approved in the United States for the treatment of relapsed chronic lymphocytic leukemia (CLL; in combination with rituximab), relapsed follicular lymphoma (FL), and small lymphocytic lymphoma (SLL) and in the European Union for the treatment of CLL (in combination with rituximab). Approval was based on clinical activity in a phase II trial in indolent non-Hodgkin lymphoma and a phase III trial in CLL. Because idelalisib is a relatively new treatment option for patients with relapsed CLL, SLL, and FL, with a safety profile distinct from other agents, it is important for advanced practitioners (APs) to familiarize themselves with the adverse event (AE) profile and educate their patients as well. As active members of the oncology care team, APs can play a vital role in optimizing outcomes in patients receiving idelalisib therapy. This review will familiarize APs with the AE profile of idelalisib and provide practical information about the identification and management of AEs associated with idelalisib therapy.