Clinical therapeutic effect of ivonib (Tosuvo) in patients with cholangiocarcinoma

Ivosidenib is an oral small molecule targeted drug that selectively inhibits the activity of isocitrate dehydrogenase 1 (IDH1) mutant enzyme. IDH1mutations account for approximately 10% to 20% of patients with cholangiocarcinoma (especially intrahepatic cholangiocarcinoma), leading to abnormal metabolism of tumor cells and promoting tumor occurrence and progression. By targeting the IDH1 mutation, Ivonib can inhibit the abnormal accumulation of 2-hydroxyglutarate (2-HG), thereby regulating cell differentiation and proliferation, and providing precise treatment options for patients with IDH1 mutation-positive advanced cholangiocarcinoma.

In clinical studies, ivonib demonstrated anti-tumor activity in patients with advanced cholangiocarcinoma. The pivotal clinical trial ClarIDHy showed that compared with placebo, ivonib significantly prolonged progression-free survival (PFS) and improved tumor control rate. Most patients can observe a slowdown in tumor growth within weeks to months of taking the drug, and some patients experience partial remission or stable disease. Research also shows that ivonib can still provide clinical benefits after previously receiving standard chemotherapy (such as gemcitabine + cisplatin), providing a new treatment option for refractory patients.

Ivonib was generally well tolerated, with common adverse reactions including fatigue, nausea, diarrhea, and mild abnormalities in hematological indicators. Compared with traditional chemotherapy, it is less toxic and patients do not need to experience severe myelosuppression or significant immunosuppression, making it suitable for long-term maintenance therapy. In clinical application, it is still necessary to monitor hematological indicators, liver and kidney functions, and electrocardiogram changes in order to adjust the dosage and deal with potential adverse events in a timely manner.

Overall, ivonib provides a highly targeted and well-tolerated treatment option for patients with IDH1 mutation-positive cholangiocarcinoma. It improves tumor control and prolongs progression-free survival by targeting IDH1 mutations, bringing new hope to patients with advanced and refractory cholangiocarcinoma. In clinical use, genetic testing results, previous treatment history and the overall status of the patient need to be combined to formulate an individualized treatment plan to achieve the best efficacy and long-term management effects.

Keyword tags: ivonib,IDH1inhibitor, cholangiocarcinoma, targeted therapy, clinical trial

Reference materials:https://reference.medscape.com/drug/tibsovo-ivosidenib-1000240