1
|
Wang H, Feng J, Liu Y, Qian Z, Gao D, Ran X, Zhou H, Liu L, Wang B, Fang M, Zhou H, Huang Z, Tao S, Chen Z, Su L, Su H, Yang Y, Xie X, Wu H, Sun P, Hu G, Liang A, Li Z. Phase II study of novel orally PI3Kα/δ inhibitor TQ-B3525 in relapsed and/or refractory follicular lymphoma. Signal Transduct Target Ther 2024; 9:99. [PMID: 38627366 PMCID: PMC11021411 DOI: 10.1038/s41392-024-01798-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 04/19/2024] Open
Abstract
This registration study assessed clinical outcomes of TQ-B3525, the dual phosphatidylinositol-3-kinase (PI3K) α/δ inhibitor, in relapsed and/or refractory follicular lymphoma (R/R FL). This phase II study (ClinicalTrials.gov NCT04324879. Registered March 27, 2020) comprised run-in stage and stage 2. R/R FL patients after ≥2 lines therapies received oral 20 mg TQ-B3525 once daily in a 28-day cycle until intolerable toxicity or disease progression. Primary endpoint was independent review committee (IRC)-assessed objective response rate (ORR). Based on results (ORR, 88.0%; duration of response [DOR], 11.8 months; progression-free survival [PFS], 12.0 months) in 25 patients at run-in stage, second stage study was initiated and included 82 patients for efficacy/safety analysis. Patients received prior-line (median, 3) therapies, with 56.1% refractory to previous last therapies; 73.2% experienced POD24 at baseline. At stage 2, ORR was 86.6% (71/82; 95% CI, 77.3-93.1%), with 28 (34.2%) complete responses. Disease control rate was 95.1% due to 7 (8.5%) stable diseases. Median time to response was 1.8 months. Among 71 responders, median DOR was not reached; 18-month DOR rate was 51.6%. with median follow-up of 13.3 months, median PFS was 18.5 (95% CI, 10.2-not estimable) months. Median overall survival (OS) was not reached by cutoff date; 24-month OS rate was estimated as 86.1%. Response rates and survival data were consistent across all subgroups. Grade 3 or higher treatment-related adverse events were observed in 63 (76.8%) cases, with neutropenia (22.0%), hyperglycemia (19.5%), and diarrhea (13.4%) being common. TQ-B3525 showed favorable efficacy and safety for R/R FL patients after ≥2 lines prior therapies.
Collapse
Affiliation(s)
- Huaqing Wang
- Department of Oncology, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, PR China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, PR China
| | - Jifeng Feng
- Department of Medical Oncology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, PR China
| | - Yanyan Liu
- Department of Medical Oncology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450003, PR China
| | - Zhengzi Qian
- Department of Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, PR China
| | - Da Gao
- Department of Hematology, The Affiliated Hospital of Inner Mongolia Medical College, 010050, Hohhot, PR China
| | - Xuehong Ran
- Department of Hematology, Weifang People's Hospital, The First Affiliated Hospital of Weifang Medical University, 261000, Weifang, PR China
| | - Hui Zhou
- Department of Lymphoma & Hematology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 410013, Changsha, PR China
| | - Lihong Liu
- Department of Hematology, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, 050011, Shijiazhuang, PR China
| | - Binghua Wang
- Department of Lymphoma, Weihai Central Hospital, 264400, Weihai, PR China
| | - Meiyun Fang
- Department of Hematology and Rheumatology, The Affiliated Zhongshan Hospital of Dalian University, 116001, Dalian, PR China
| | - Hebing Zhou
- Department of Hematology, Beijing Luhe Hospital, 101199, Beijing, PR China
| | - Zhenqian Huang
- Department of Hematology, The First Affiliated Hospital of Guangzhou Medical University, 510120, Guangzhou, PR China
| | - Shi Tao
- Department of Hematology, The First Affiliated Hospital of Hainan Medical College, 570102, Haikou, PR China
| | - Zhuowen Chen
- Department of Hematology, The First People's Hospital of Foshan, 528000, Foshan, PR China
| | - Liping Su
- Department of Hematology, Shanxi Cancer Hospital, 030013, Taiyuan, PR China
| | - Hang Su
- Department of Lymphoma, Senior Department of Hematology, The Fifth Medical Center of Chinese PLA General Hospital, 100039, Beijing, PR China
| | - Yu Yang
- Department of Lymphoma and Head and Neck Cancer, Fujian Cancer Hospital, 350014, Fuzhou, PR China
| | - Xiaobao Xie
- Department of Hematology, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, PR China
| | - Huijing Wu
- Department of Medical Oncology, Hubei Cancer Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, 430079, Wuhan, PR China
| | - Ping Sun
- Department of Medical Oncology, Yantai Yuhuangding Hospital, 264000, Yantai, PR China
| | - Guoyu Hu
- Department of Hematology, Zhuzhou Central Hospital, 412007, Zhuzhou, PR China
| | - Aibin Liang
- Department of Hematology, Tongji Hospital of Tongji University, Shanghai, 200333, PR China.
| | - Zhiming Li
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 510060, Guangzhou, PR China.
| |
Collapse
|
2
|
Liu Y, Sun Q, Wei X. Strategies and techniques for preclinical therapeutic targeting of PI3K in oncology: where do we stand in 2024? Expert Opin Ther Targets 2024; 28:221-232. [PMID: 38646899 DOI: 10.1080/14728222.2024.2342522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/06/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION The PI3K/AKT/mTOR signaling pathway is an important signaling pathway in eukaryotic cells that is activated in a variety of cancers and is also associated with treatment resistance. This signaling pathway is an important target for anticancer therapy and holds great promise for research. At the same time PI3K inhibitors have a general problem that they have unavoidable toxic side effects. AREAS COVERED This review provides an explanation of the role of PI3K in the development and progression of cancer, including several important mutations, and a table listing the cancers caused by these mutations. We discuss the current landscape of PI3K inhibitors in preclinical and clinical trials, address the mechanisms of resistance to PI3K inhibition along with their associated toxic effects, and highlight significant advancements in preclinical research of this field. Furthermore, based on our study and comprehension of PI3K, we provide a recapitulation of the key lessons learned from the research process and propose potential measures for improvement that could prove valuable. EXPERT OPINION The PI3K pathway is a biological pathway of great potential value. However, the reduction of its toxic side effects and combination therapies need to be further investigated.
Collapse
Affiliation(s)
- Yanyan Liu
- Laboratory of Aging Research and Cancer Drug Target, Department of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, People's Republic of China
| | - Qiu Sun
- Laboratory of Aging Research and Cancer Drug Target, Department of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, People's Republic of China
- West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, China
| | - Xiawei Wei
- Laboratory of Aging Research and Cancer Drug Target, Department of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, People's Republic of China
| |
Collapse
|
3
|
Hu J, Fu S, Zhan Z, Zhang J. Advancements in dual-target inhibitors of PI3K for tumor therapy: Clinical progress, development strategies, prospects. Eur J Med Chem 2024; 265:116109. [PMID: 38183777 DOI: 10.1016/j.ejmech.2023.116109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
Phosphoinositide 3-kinases (PI3Ks) modify lipids by the phosphorylation of inositol phospholipids at the 3'-OH position, thereby participating in signal transduction and exerting effects on various physiological processes such as cell growth, metabolism, and organism development. PI3K activation also drives cancer cell growth, survival, and metabolism, with genetic dysregulation of this pathway observed in diverse human cancers. Therefore, this target is considered a promising potential therapeutic target for various types of cancer. Currently, several selective PI3K inhibitors and one dual-target PI3K inhibitor have been approved and launched on the market. However, the majority of these inhibitors have faced revocation or voluntary withdrawal of indications due to concerns regarding their adverse effects. This article provides a comprehensive review of the structure and biological functions, and clinical status of PI3K inhibitors, with a specific emphasis on the development strategies and structure-activity relationships of dual-target PI3K inhibitors. The findings offer valuable insights and future directions for the development of highly promising dual-target drugs targeting PI3K.
Collapse
Affiliation(s)
- Jiarui Hu
- Department of Neurology, Joint Research Institution of Altitude Health and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; State Key Laboratory of Biotherapy and Cancer Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Siyu Fu
- Department of Neurology, Joint Research Institution of Altitude Health and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; State Key Laboratory of Biotherapy and Cancer Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Zixuan Zhan
- Department of Neurology, Joint Research Institution of Altitude Health and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jifa Zhang
- Department of Neurology, Joint Research Institution of Altitude Health and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; State Key Laboratory of Biotherapy and Cancer Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| |
Collapse
|
4
|
Witkowska M, Majchrzak A, Robak P, Wolska-Washer A, Robak T. Metabolic and toxicological considerations for phosphoinositide 3-kinase delta inhibitors in the treatment of chronic lymphocytic leukemia. Expert Opin Drug Metab Toxicol 2023; 19:617-633. [PMID: 37714711 DOI: 10.1080/17425255.2023.2260305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 09/17/2023]
Abstract
INTRODUCTION Phosphoinositide 3-kinase delta (PI3Kδ) inhibitors are a class of novel agents that are mainly used to treat B-cell malignancies. They function by inhibiting one or more enzymes which are part of the PI3K/AKT/mTOR pathway. Idelalisib is a first-in-class PI3Kδ inhibitor effective in patients with B-cell lymphoid malignancies. AREAS COVERED This article reviews the chemical structure, mechanism of action, and metabolic and toxicological properties of PI3Kδ inhibitors and discusses their clinical applications in monotherapy and in combination with other agents for the treatment of chronic lymphocytic leukemia (CLL). A search was conducted of PubMed, Web of Science, and Google Scholar for articles in English. RESULTS/CONCLUSION PI3Kδ inhibitors hold potential for the treatment of B-cell malignancies, including CLL. However, their use is also associated with severe toxicities, including pneumonia, cytopenias, hepatitis, and rash. Newer drugs are in development to reduce toxicity with novel schedules and/or combinations. EXPERT OPINION The development of novel PI3Kδ inhibitors might help to reduce toxicity and improve efficacy in patients with CLL and other B-cell lymphoid malignancies.
Collapse
Affiliation(s)
- Magdalena Witkowska
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland
| | - Agata Majchrzak
- Department of General Hematology, Copernicus Memorial Hospital, Lodz, Poland
| | - Paweł Robak
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland
| | - Anna Wolska-Washer
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland
| | - Tadeusz Robak
- Department of General Hematology, Copernicus Memorial Hospital, Lodz, Poland
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| |
Collapse
|