NCCN Guidelines for Patients® | Follicular Lymphoma Grade 1-2

29 NCCN Guidelines for Patients ® : Follicular Lymphoma, Grade 1–2, 2017 3 Overview of cancer treatments Targeted therapy Targeted therapy Targeted therapy is a class of drugs. These drugs stop the action of molecules that help cancer cells grow. They are less likely to harm normal cells than chemotherapy. Targeted therapy for follicular lymphoma uses kinase inhibitors. Kinases are molecules that move chemicals, called phosphates, from one molecule to another. The targeted kinase in follicular lymphoma is PI3K ( p hospho i nositide 3 - k inase delta). PI3K is found inside of B-cells. It helps cells grow and survive. There are two PI3K kinase inhibitors used to treat follicular lymphoma. Both are briefly described next. Ask your treatment team for a full list of common and rare side effects. Idelalisib Idelalisib (Zydelig ® ) targets one form of PI3K called delta. It slows down follicular lymphoma. It works by causing cell death. It also stops the cells from quickly making new cells. Third, it stops the cells from moving into your bone and marrow. Idelalisib is made in pill form. It is taken twice a day with or without food. Your doctor will tell you how many pills you need for your dose. Common side effects of idelalisib include diarrhea, fatigue, nausea, cough, fever, belly pain, lung infections, and rash. White blood counts are often low when taking this medicine. However, there may be a short-lived increase in lymphocytes at first. Your doctor will assess for serious but uncommon side effects. These include liver and lung problems. You may develop severe skin problems or diarrhea. Idelalisib can also cause tears in your gut. Do not take idelalisib if pregnant or breast feeding. Copanlisib Copanlisib (ALIQOPA™) mainly targets two forms of PI3K—alpha and delta. It works by causing cell death. It also stops the cells from quickly making new cells. Third, it stops the cells from moving into your bone and marrow. Copanlisib is a liquid that will be slowly injected into your vein. It is received on Days 1, 8, and 15 during a 28-day cycle. It takes about 1 hour to receive the full dose. Common side effects of copanlisib include high blood sugar (hyperglycemia) and pressure (hypertension). Some blood counts are often low when taking this medicine. You may also have diarrhea, feel tired and weak, and get a lung infection. Your doctor will assess for serious but uncommon side effects. These include lung problems. You may develop severe skin problems or diarrhea. Do not take copanlisib if pregnant or breast feeding.

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