Treatment Name: Duvelisib (Copiktra®)
How does duvelisib work?
Duvelisib is a chemotherapy drug that works by turning off a protein called PI3K (phosphatidylinositol 3-kinase), which stops cancerous B-lymphocytes from growing and dividing, plus kills the cancer cells.
Goals of therapy:
Duvelisib is taken to alleviate symptoms of CLL such as enlarged lymph nodes, enlarged liver or spleen, or symptoms of abnormal bone marrow function, such as frequent infection. It is not commonly given with the goal of cure.
- Usual starting dose: one 25 mg oral capsule by mouth twice daily with or without food
Duvelisib is prescribed by a cancer doctor and usually taken at home until the drug no longer works or until unacceptable side effects occur.
Note: Individual doses may vary based upon your Doctor's recommendation, or drug availability.
In clinical studies, the most commonly reported duvelisib side effects (all grades) are shown here.
- Diarrhea (51%)
- Neutropenia [Low white blood cells] (33%)
- Fever (29%)
- Nausea (23%)
- Anemia [low red blood cells] (23%)
- Cough (21%)
- Pneumonia (18%)
- Constipation (17%)
- Sinus infection (16%)
- Vomiting (15%)
- Thrombocytopenia [low platelets] (15%)
- Bronchitis (13%)
- Inflammation of the colon (13%)
- Fatigue (13%)
- Decreased appetite (13%)
- Weight loss (11%)
- Weakness (11%)
- Stomach pain (10%)
- Shortness of breath (10%)
- Rash (10%)
- Liver injury (3%)
On average, 35% of patients discontinue duvelisib treatment due to unacceptable side effects.
How often is monitoring needed?
Labs (blood tests) may be checked before treatment, every 1 to 2 weeks during the first two months of treatment, then periodically thereafter as directed by your doctor. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked if there are concerns for infection or other side effects. Imaging may include: X-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue duvelisib treatment as planned, reduce the duvelisib dose, delay treatment until the duvelisib side effect goes away, or switch to an alternative therapy.
- Severe diarrhea can occur and may not respond to conventional anti-diarrheal medications such as loperamide (Imodium®). If you are experiencing diarrhea that does not respond to anti-diarrheal treatment, contact your doctor as uncontrolled diarrhea can lead to dehydration and significant blood electrolyte abnormalities
- Although rare, serious lung injuries can occur. Report and new or increasing shortness of breath, cough, wheezing, or chest pain to your doctor as these could be signs of lung injury and may need treatment with corticosteroids such as prednisone or methylprednisolone (Solu-Medrol®)
- A very rare fungal infection known as pneumocystis jirovecii (PJP) in the lungs have been reported. Medications such as sulfamethoxazole/trimethoprim (Bactrim®) may be used while on duvelisib to prevent this type of infection. 75% of infections occurred within the first six months of beginning treatment
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for CLL Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Duvelisib (Copiktra®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Duvelisib (Copiktra®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Duvelisib (Copiktra®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Duvelisib (Copiktra®)