Rethinking Clinical Response and Outcome Assessment in a Biologic Age

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The drug induces an early lymphocytosis caused by a demargination of lymphocytes which could be confused with progressive disease, although other clinical and loboratory disease features are improving. Gopal AK, Kahl BS, de Vos S, et al. PI3Kδ inhibition by idelalisib in patients with indolent lymphoma. N Engl J Med. 2014;370:1008–18. Kahl BS, Spurgeon SE, Furman RR, et al. Results of a phase I study of idelalisib, a PI3Kδ inhibitor, in patients with relapsed or refractory mantle cell lymphoma (MCL). Blood. 2014;123:3398–405. Wang M, Rule S, Martin P, et al. Targeting BTK with ibrutinib in relapsed or refractory mantle-cell lymphoma. N Engl J Med. 2013;369:507–15. Byrd JC, Brown JR, O'Brien SM, et al. Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia. N Engl J Med. 2014;371:213–23. In this randomized trial, ibrutinib outperformed ofatumumab and prolonged survival. 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