Common brand names

• Copiktra

How it is administered

Duvelisib is taken by mouth as a capsule. The recommended dose is 25 mg twice daily, with or without food. The capsules should be swallowed whole and not opened, broken, or chewed. If you miss a dose by less than 6 hours, take it right away and continue as usual. If more than 6 hours have passed, skip the missed dose and take the next dose at the usual time.

How it works

Duvelisib is a targeted therapy known as a kinase inhibitor. It works by blocking specific proteins in cells called PI3K-δ and PI3K-γ, which are involved in the growth and survival of certain blood cancer cells, including those in follicular lymphoma and other B-cell malignancies. By inhibiting these proteins, duvelisib disrupts important cell signaling pathways that cancer cells use to grow, divide, and migrate. This can slow down or stop the progression of the disease.

Duvelisib also affects the immune environment around the cancer by reducing the movement of certain immune cells and decreasing signals that help cancer cells survive. This dual action helps to control the spread of cancer and can lead to a reduction in tumor size or a delay in disease progression.

Who should take it

Duvelisib is indicated for adults with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have already received at least two prior therapies. It may also be considered for some patients with follicular lymphoma who have not responded to other treatments, as it has shown activity in B-cell malignancies, including follicular lymphoma, in clinical trials.

It is not recommended as a first or second line treatment for CLL or SLL due to an increased risk of treatment-related mortality. Your healthcare provider will determine if duvelisib is appropriate for you based on your previous treatments and overall health.

Who should not take it

Duvelisib should not be used in patients who are pregnant, as it can cause harm to an unborn baby. Women of reproductive potential and men with female partners of reproductive potential should use effective contraception during treatment and for at least 1 month after the last dose.

There are no absolute contraindications listed, but duvelisib should be used with caution in patients with active, uncontrolled infections, significant liver problems, or those who have experienced severe reactions to similar medications. Always tell your healthcare provider about your full medical history before starting duvelisib.

Commonly used with

Duvelisib is usually used alone when treating relapsed or refractory CLL, SLL, or follicular lymphoma after other treatments have failed. It may be given with supportive medications such as antibiotics or antivirals to prevent infections, especially Pneumocystis jirovecii pneumonia (PJP) and cytomegalovirus (CMV) reactivation.

Your doctor may also prescribe medications to help manage side effects, such as antidiarrheal agents, steroids for inflammation, or medications to support blood counts.

Commonly tested with

In clinical studies, duvelisib has been compared with other treatments such as ofatumumab (an antibody therapy) in patients with relapsed or refractory CLL or SLL. It has also been studied in combination with supportive care medications to prevent infections and manage side effects.

Duvelisib is sometimes tested alongside other targeted therapies or immunotherapies in research settings, but its primary use is as a single agent in patients who have already tried other lines of therapy.