activated PI3K-delta syndrome

disease
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Also known as APDSsenescent T-cells-lymphadenopathy-immunodeficiency syndrome due to p110delta-activating mutation

Summary

activated PI3K-delta syndrome (MONDO:0018338) is a disease with 3 cohort genes and 5 clinical trials. The dominant Reactome pathway is Synthesis of PIPs at the plasma membrane (3 cohort genes). Top therapeutic interventions include leniolisib, sirolimus, and nemiralisib.

At a glance

  • Prevalence: Unknown (Worldwide) [Orphanet-validated]
  • Cohort genes: 3
  • ClinVar variants: 43
  • Phenotypes (HPO): 24
  • Clinical trials: 5

Clinical features

Epidemiology

Prevalence records

1 prevalence record(s), Orphanet:

TypeClassValueGeographyValidation
Cases/families250WorldwideValidated

Signs & symptoms

Clinical features (HPO)

24 HPO clinical features (Orphanet curated; top 24 by frequency):

HPO IDTermFrequency
HP:0002090PneumoniaVery frequent (80-99%)
HP:0200117Recurrent upper and lower respiratory tract infectionsVery frequent (80-99%)
HP:0000403Recurrent otitis mediaFrequent (30-79%)
HP:0001744SplenomegalyFrequent (30-79%)
HP:0002110BronchiectasisFrequent (30-79%)
HP:0002240HepatomegalyFrequent (30-79%)
HP:0002716LymphadenopathyFrequent (30-79%)
HP:0002960AutoimmunityFrequent (30-79%)
HP:0003496Increased circulating IgM levelFrequent (30-79%)
HP:0004313Decreased circulating antibody levelFrequent (30-79%)
HP:0010976Decreased total B cell countFrequent (30-79%)
HP:0011109Chronic sinusitisFrequent (30-79%)
HP:0011956Intestinal lymphoid nodular hyperplasiaFrequent (30-79%)
HP:0000252MicrocephalyOccasional (5-29%)
HP:0000365Hearing impairmentOccasional (5-29%)
HP:0001369ArthritisOccasional (5-29%)
HP:0001508Failure to thriveOccasional (5-29%)
HP:0002242Abnormal intestine morphologyOccasional (5-29%)
HP:0002665LymphomaOccasional (5-29%)
HP:0011110Recurrent tonsillitisOccasional (5-29%)
HP:0012758Neurodevelopmental delayOccasional (5-29%)
HP:0031692Severe cytomegalovirus infectionOccasional (5-29%)
HP:0031693Severe Epstein Barr virus infectionOccasional (5-29%)
HP:0032170Severe varicella zoster infectionOccasional (5-29%)

Identifiers

Disease identifiers

FieldValue
Canonical nameactivated PI3K-delta syndrome
Mondo IDMONDO:0018338
MeSHC585640
Orphanet397596
SNOMED CT711480000
GARD0011983
Is cancer (heuristic)no

Also known as: APDS · senescent T-cells-lymphadenopathy-immunodeficiency syndrome due to p110delta-activating mutation

Data availability: 43 ClinVar variants · 3 GenCC gene-disease records.

Disease family

An umbrella term covering 2 Mondo subtypes.

Classification path: disease › human disease › disease by body system or component › immune system disorderinborn error of immunityB cell deficiencyagammaglobulinemiaactivated PI3K-delta syndrome

Related subtypes (9): congenital agammaglobulinemia, immunodeficiency 61, Good syndrome, isolated agammaglobulinemia, syndromic agammaglobulinemia, agammaglobulinemia 9, autosomal recessive, agammaglobulinemia 10, autosomal dominant, agammaglobulinemia, autosomal recessive, due to BOB1 deficiency, agammaglobulinemia 8b, autosomal recessive

Subtypes (2): immunodeficiency 14, immunodeficiency 36 with lymphoproliferation

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

43 retrieved; paginated sample, class counts are floors:

36 uncertain significance, 6 likely benign, 1 conflicting classifications of pathogenicity

ClinVarVariant (HGVS)GeneClassificationReview
1047215NM_181523.3(PIK3R1):c.343C>G (p.Leu115Val)PIK3R1Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
1495102NM_005026.5(PIK3CD):c.1057A>G (p.Met353Val)LOC126805612Uncertain significancecriteria provided, single submitter
4075729NM_005026.5(PIK3CD):c.1318T>C (p.Tyr440His)LOC126805612Uncertain significancecriteria provided, single submitter
1035901NM_005026.5(PIK3CD):c.2503G>A (p.Ala835Thr)PIK3CDUncertain significancecriteria provided, single submitter
1038802NM_005026.5(PIK3CD):c.1478A>C (p.Glu493Ala)PIK3CDUncertain significancecriteria provided, single submitter
1041355NM_005026.5(PIK3CD):c.866A>G (p.Gln289Arg)PIK3CDUncertain significancecriteria provided, single submitter
1056408NM_005026.5(PIK3CD):c.923C>T (p.Ala308Val)PIK3CDUncertain significancecriteria provided, single submitter
1061373NM_005026.5(PIK3CD):c.1402G>A (p.Ala468Thr)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
1162831NM_005026.5(PIK3CD):c.2461C>T (p.Arg821Cys)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
1328117NM_005026.5(PIK3CD):c.1579G>A (p.Glu527Lys)PIK3CDUncertain significancecriteria provided, single submitter
1399114NM_005026.5(PIK3CD):c.1121G>A (p.Arg374Gln)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
2110452NM_005026.5(PIK3CD):c.113G>T (p.Arg38Leu)PIK3CDUncertain significancecriteria provided, single submitter
2572869NM_005026.5(PIK3CD):c.3057T>A (p.Phe1019Leu)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
2805124NM_005026.5(PIK3CD):c.2863C>T (p.Arg955Trp)PIK3CDUncertain significancecriteria provided, single submitter
2866391NM_005026.5(PIK3CD):c.1738C>G (p.Leu580Val)PIK3CDUncertain significancecriteria provided, single submitter
2890917NM_005026.5(PIK3CD):c.2945G>A (p.Arg982Gln)PIK3CDUncertain significancecriteria provided, single submitter
3418574NM_005026.5(PIK3CD):c.2117C>A (p.Thr706Asn)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
3615597NM_005026.5(PIK3CD):c.896C>T (p.Pro299Leu)PIK3CDUncertain significancecriteria provided, single submitter
659165NM_005026.5(PIK3CD):c.692C>T (p.Pro231Leu)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
663967NM_005026.5(PIK3CD):c.2320G>A (p.Val774Met)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
845740NM_005026.5(PIK3CD):c.2869C>T (p.Arg957Trp)PIK3CDUncertain significancecriteria provided, single submitter
850940NM_005026.5(PIK3CD):c.971G>A (p.Arg324His)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
943206NM_005026.5(PIK3CD):c.5C>T (p.Pro2Leu)PIK3CDUncertain significancecriteria provided, single submitter
951744NM_005026.5(PIK3CD):c.401C>T (p.Pro134Leu)PIK3CDUncertain significancecriteria provided, single submitter
960245NM_005026.5(PIK3CD):c.2206G>A (p.Asp736Asn)PIK3CDUncertain significancecriteria provided, multiple submitters, no conflicts
963563NM_005026.5(PIK3CD):c.221A>G (p.Asn74Ser)PIK3CDUncertain significancecriteria provided, single submitter
965978NM_005026.5(PIK3CD):c.155G>A (p.Arg52His)PIK3CDUncertain significancecriteria provided, single submitter
1337679NM_181523.3(PIK3R1):c.406G>A (p.Val136Met)PIK3R1Uncertain significancecriteria provided, multiple submitters, no conflicts
1491282NM_181523.3(PIK3R1):c.604G>A (p.Val202Ile)PIK3R1Uncertain significancecriteria provided, multiple submitters, no conflicts
2921958NM_181523.3(PIK3R1):c.949G>A (p.Val317Ile)PIK3R1Uncertain significancecriteria provided, single submitter

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 37 · Orphanet: 20 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

GeneClassificationInheritanceDiseaseRecords
PIK3CDSupportiveAutosomal dominantactivated PI3K-delta syndrome7
PIK3R1SupportiveAutosomal dominantactivated PI3K-delta syndrome13
PTENSupportiveAutosomal dominantactivated PI3K-delta syndrome17

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
PIK3CDOrphanet:221139Combined immunodeficiency with facio-oculo-skeletal anomalies
PIK3CDOrphanet:33110Autosomal non-syndromic agammaglobulinemia
PIK3CDOrphanet:693661Activated PI3K-delta syndrome 1
PIK3R1Orphanet:3163SHORT syndrome
PIK3R1Orphanet:33110Autosomal non-syndromic agammaglobulinemia
PIK3R1Orphanet:693681Activated PI3K-delta syndrome 2
PTENOrphanet:109Bannayan-Riley-Ruvalcaba syndrome
PTENOrphanet:137608Segmental outgrowth-lipomatosis-arteriovenous malformation-epidermal nevus syndrome
PTENOrphanet:145Hereditary breast and/or ovarian cancer syndrome
PTENOrphanet:201Cowden syndrome
PTENOrphanet:210548Macrocephaly-intellectual disability-autism syndrome
PTENOrphanet:2969Proteus-like syndrome
PTENOrphanet:494547Squamous cell carcinoma of the hypopharynx
PTENOrphanet:494550Squamous cell carcinoma of the larynx
PTENOrphanet:500464Squamous cell carcinoma of the nasal cavity and paranasal sinuses
PTENOrphanet:500478Squamous cell carcinoma of the oropharynx
PTENOrphanet:502363Squamous cell carcinoma of the oral cavity
PTENOrphanet:502366Squamous cell carcinoma of the lip
PTENOrphanet:65285Lhermitte-Duclos disease
PTENOrphanet:79076Juvenile polyposis of infancy

Cohort genes → proteins

3 cohort genes, 3 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence3

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
PIK3CDHGNC:8977ENSG00000171608O00329Phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit delta isoformgencc,clinvar
PIK3R1HGNC:8979ENSG00000145675P27986Phosphatidylinositol 3-kinase regulatory subunit alphagencc,clinvar
PTENHGNC:9588ENSG00000171862P60484Phosphatidylinositol 3,4,5-trisphosphate 3-phosphatase and dual-specificity protein phosphatase PTENgencc

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
PIK3CDPhosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit delta isoformPhosphoinositide-3-kinase (PI3K) phosphorylates phosphatidylinositol (PI) and its phosphorylated derivatives at position 3 of the inositol ring to produce 3-phosphoinositides.
PIK3R1Phosphatidylinositol 3-kinase regulatory subunit alphaBinds to activated (phosphorylated) protein-Tyr kinases, through its SH2 domain, and acts as an adapter, mediating the association of the p110 catalytic unit to the plasma membrane.
PTENPhosphatidylinositol 3,4,5-trisphosphate 3-phosphatase and dual-specificity protein phosphatase PTENDual-specificity protein phosphatase, dephosphorylating tyrosine-, serine- and threonine-phosphorylated proteins.

Protein-family classification

Druggable: 3 · Difficult: 0 · Unknown: 0 · Druggable fraction: 1.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Kinase218.5×0.008
Phosphatase128.0×0.035

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
PIK3CDKinaseyes2.7.1.137PI3K_Ras-bd_dom, PI3/4_kinase_cat_dom, PI3K_accessory_dom
PIK3R1Kinaseyes2.7.1.153RhoGAP_dom, SH2, SH3_domain
PTENPhosphataseyes3.1.3.16Tyr_Pase_dom, Tyr_Pase_cat, Tensin_C2-dom

Expression context

Cohort genes with no expression data: 0.

3 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)3
unknown0

Top tissues across cohort

TissueCohort genes
calcaneal tendon2
blood1
granulocyte1
lymph node1
caput epididymis1
corpus epididymis1
endothelial cell1
sperm1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
PIK3CD253ubiquitousmarkergranulocyte, blood, lymph node
PIK3R1294ubiquitousmarkercalcaneal tendon, caput epididymis, corpus epididymis
PTEN256ubiquitousmarkersperm, endothelial cell, calcaneal tendon

Protein interactions among cohort

Intra-cohort edges: 2.

Hub genes (top 10 by interactor count)

SymbolInteractor count
PTEN11,626
PIK3R15,168
PIK3CD2,059

Intra-cohort edges

ABSources
PIK3CDPIK3R1biogrid_interaction, intact, string_interaction
PIK3R1PTENstring_interaction

Structural data

PDB: 3 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
PIK3R1P27986105
PIK3CDO0032918
PTENP6048412

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 90. Enrichment computed across 3 evidence-associated genes (3 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 3 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Synthesis of PIPs at the plasma membrane3211.5×9e-06PIK3CD, PIK3R1, PTEN
Co-stimulation by ICOS2692.1×9e-05PIK3CD, PIK3R1
Erythropoietin activates Phosphoinositide-3-kinase (PI3K)2634.4×9e-05PIK3CD, PIK3R1
Regulation of signaling by CBL2331.0×3e-04PIK3CD, PIK3R1
Interleukin receptor SHC signaling2271.9×3e-04PIK3CD, PIK3R1
CD28 dependent PI3K/Akt signaling2262.5×3e-04PIK3CD, PIK3R1
Antigen activates B Cell Receptor (BCR) leading to generation of second messengers2237.9×3e-04PIK3CD, PIK3R1
Signaling by CSF1 (M-CSF) in myeloid cells2230.7×3e-04PIK3CD, PIK3R1
Interleukin-3, Interleukin-5 and GM-CSF signaling2211.5×3e-04PIK3CD, PIK3R1
RET signaling2173.0×4e-04PIK3CD, PIK3R1
Downstream TCR signaling285.5×0.001PIK3R1, PTEN
Constitutive Signaling by Aberrant PI3K in Cancer284.6×0.001PIK3CD, PIK3R1
PI5P, PP2A and IER3 Regulate PI3K/AKT Signaling264.5×0.002PIK3CD, PIK3R1
PTEN Loss of Function in Cancer11903.3×0.003PTEN
PIP3 activates AKT signaling244.5×0.004PIK3CD, PIK3R1
MET activates PI3K/AKT signaling1634.4×0.008PIK3R1
Activated NTRK3 signals through PI3K1634.4×0.008PIK3R1
Activated NTRK2 signals through PI3K1543.8×0.009PIK3R1
Signaling by LTK in cancer1543.8×0.009PIK3R1
PI3K/AKT activation1423.0×0.011PIK3R1
Regulation of PTEN mRNA translation1380.7×0.011PTEN
IRS-mediated signalling1346.1×0.011PIK3R1
PI3K events in ERBB4 signaling1346.1×0.011PIK3R1
Regulation of PTEN localization1346.1×0.011PTEN
GP1b-IX-V activation signalling1317.2×0.011PIK3R1
Signaling by FGFR4 in disease1317.2×0.011PIK3R1
Signaling by PDGFRA transmembrane, juxtamembrane and kinase domain mutants1292.8×0.011PIK3R1
Signaling by PDGFRA extracellular domain mutants1292.8×0.011PIK3R1
Signaling by LTK1292.8×0.011PIK3R1
Signaling by FLT3 ITD and TKD mutants1253.8×0.011PIK3R1

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 3 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
phosphatidylinositol 3-kinase/protein kinase B signal transduction3210.7×1e-05PIK3CD, PIK3R1, PTEN
T cell differentiation2255.3×0.001PIK3CD, PIK3R1
B cell differentiation2145.9×0.003PIK3CD, PIK3R1
natural killer cell chemotaxis12808.7×0.007PIK3CD
negative regulation of synaptic vesicle clustering12808.7×0.007PTEN
regulation of toll-like receptor 4 signaling pathway11872.4×0.007PIK3R1
negative regulation of keratinocyte migration11872.4×0.007PTEN
positive regulation of endoplasmic reticulum unfolded protein response11872.4×0.007PIK3R1
mast cell chemotaxis11404.3×0.007PIK3CD
respiratory burst involved in defense response11404.3×0.007PIK3CD
rhythmic synaptic transmission11404.3×0.007PTEN
mast cell differentiation11404.3×0.007PIK3CD
myeloid leukocyte migration11404.3×0.007PIK3R1
positive regulation of neutrophil apoptotic process11123.5×0.007PIK3CD
central nervous system myelin maintenance1936.2×0.007PTEN
interleukin-18-mediated signaling pathway1936.2×0.007PIK3R1
B cell chemotaxis1936.2×0.007PIK3CD
neutrophil extravasation1936.2×0.007PIK3CD
positive regulation of epithelial tube formation1936.2×0.007PIK3CD
protein stabilization244.6×0.007PIK3R1, PTEN
cell migration241.0×0.007PIK3CD, PTEN
negative regulation of cell cycle G1/S phase transition1802.5×0.007PTEN
negative regulation of wound healing, spreading of epidermal cells1802.5×0.007PTEN
immune response231.4×0.007PIK3CD, PIK3R1
spindle assembly involved in female meiosis1624.1×0.007PTEN
central nervous system neuron axonogenesis1624.1×0.007PTEN
postsynaptic density assembly1624.1×0.007PTEN
positive regulation of focal adhesion disassembly1624.1×0.007PIK3R1
neuron-neuron synaptic transmission1561.7×0.007PTEN
negative regulation of peptidyl-serine phosphorylation1561.7×0.007PTEN

Therapeutics

Drug target analysis

Approved (phase 4): 2 · Phase ≥3: 2 · Phased (≥1): 2 · Undrugged: 1

Druggability breadth: 3 of 3 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

SymbolExample approved molecule
PIK3CDIDELALISIB
PIK3R1IDELALISIB

Top cohort targets by molecule count

SymbolMoleculesMax phase
PIK3CD664
PIK3R1264
PTEN00

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
IDELALISIB4PIK3CD, PIK3R1
ALPELISIB4PIK3CD, PIK3R1
DUVELISIB4PIK3CD, PIK3R1
COPANLISIB4PIK3CD, PIK3R1
UMBRALISIB4PIK3CD, PIK3R1
CAFFEINE4PIK3CD
THEOPHYLLINE4PIK3CD
COPANLISIB HYDROCHLORIDE4PIK3CD
LENIOLISIB4PIK3CD
INAVOLISIB4PIK3CD
SUNITINIB4PIK3CD
DASATINIB4PIK3CD
DACTOLISIB3PIK3CD, PIK3R1
BUPARLISIB3PIK3CD, PIK3R1
TASELISIB3PIK3CD
PARSACLISIB3PIK3CD
POVORCITINIB3PIK3CD
GEDATOLISIB3PIK3CD
LESTAURTINIB3PIK3CD
QUERCETIN3PIK3R1
OMIPALISIB2PIK3CD, PIK3R1
GSK-26367712PIK3CD, PIK3R1
FIMEPINOSTAT2PIK3CD, PIK3R1
EGANELISIB2PIK3CD, PIK3R1
AMDIZALISIB2PIK3CD, PIK3R1
RISOVALISIB2PIK3CD, PIK3R1
PICTILISIB2PIK3CD, PIK3R1
ZSTK-4742PIK3CD, PIK3R1
PF-046915022PIK3CD
IZORLISIB2PIK3CD

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 3.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
PIK3CD1,111Binding:1094, ADMET:8, Functional:8, Toxicity:1
PIK3R1493Binding:470, ADMET:23
PTEN8Binding:8

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
PIK3CD2.7.1.137, 2.7.1.153, 2.7.11.1phosphatidylinositol 3-kinase, phosphatidylinositol-4,5-bisphosphate 3-kinase, non-specific serine/threonine protein kinase
PIK3R12.7.1.153phosphatidylinositol-4,5-bisphosphate 3-kinase
PTEN3.1.3.16, 3.1.3.67protein-serine/threonine phosphatase, phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase

Cohort genes with high screening signal

≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.

SymbolChEMBL assays
PIK3CD1,111
PIK3R1493

Pharmacogenomics

Cohort genes with a PharmGKB record: 3; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

29 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

CompoundMax phaseCohort target (bioactivity)
IDELALISIB4PIK3CD, PIK3R1
ALPELISIB4PIK3CD, PIK3R1
DUVELISIB4PIK3CD, PIK3R1
COPANLISIB4PIK3CD, PIK3R1
UMBRALISIB4PIK3CD, PIK3R1
CAFFEINE4PIK3CD
THEOPHYLLINE4PIK3CD
COPANLISIB HYDROCHLORIDE4PIK3CD
INAVOLISIB4PIK3CD
SUNITINIB4PIK3CD
DASATINIB4PIK3CD
DACTOLISIB3PIK3CD, PIK3R1
BUPARLISIB3PIK3CD, PIK3R1
TASELISIB3PIK3CD
PARSACLISIB3PIK3CD
POVORCITINIB3PIK3CD
GEDATOLISIB3PIK3CD
LESTAURTINIB3PIK3CD
QUERCETIN3PIK3R1
OMIPALISIB2PIK3CD, PIK3R1
GSK-26367712PIK3CD, PIK3R1
FIMEPINOSTAT2PIK3CD, PIK3R1
EGANELISIB2PIK3CD, PIK3R1
AMDIZALISIB2PIK3CD, PIK3R1
RISOVALISIB2PIK3CD, PIK3R1
PICTILISIB2PIK3CD, PIK3R1
ZSTK-4742PIK3CD, PIK3R1
PF-046915022PIK3CD
IZORLISIB2PIK3CD

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)2PIK3CD, PIK3R1
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug1PTEN
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug0

Undrugged target profiles

1 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
PTEN8

Clinical trials & evidence

Clinical trials

Clinical trials: 5.

Phase distribution (across all retrieved trials)

PhaseTrials
PHASE32
PHASE21
PHASE1/PHASE21
Not specified1

Top trials by phase / activity

NCTPhaseStatusTitle
NCT05438407PHASE3ACTIVE_NOT_RECRUITINGPediatric Patients Aged 4 to 11 Years With APDS
NCT05693129PHASE3ACTIVE_NOT_RECRUITINGPediatric Patients Aged 1 to 6 Years With APDS
NCT02593539PHASE2COMPLETEDSafety, Pharmacokinetic (PK) and Pharmacodynamic (PD) Study of Repeat Doses of Inhaled Nemiralisib in Patients With APDS/PASLI
NCT03383380PHASE1/PHASE2COMPLETEDRapamycin Treatment for Activated Phosphoinositide 3-Kinase δ Syndrome
NCT06694363Not specifiedRECRUITINGNew Biomarker-based Strategy to Screen and Monitor for Activated Phosphoinositide 3-kinase δ Syndrome

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
LENIOLISIB42
SIROLIMUS41
NEMIRALISIB21
CHEMBL364340902