Bendamustine: a review of its use in the management of indolent non-Hodgkin lymphoma.
Bendamustine (Treanda, Ribomustin) is a bifunctional alkylating agent that also has potential antimetabolite properties, and only partial cross-resistance occurs between bendamustine and other alkylators. In patients with indolent non-Hodgkin lymphoma (NHL), bendamustine monotherapy achieved high objective response rates in those with rituximab-refractory disease in a pivotal noncomparative trial and a similarly designed smaller phase II study. Many of these heavily treated patients were also refractory to standard chemotherapy regimens. Several phase II trials demonstrated good response rates with single-agent bendamustine, or bendamustine in combination with rituximab, in patients with indolent NHL whose disease relapsed after (or was refractory to) chemotherapy. Phase III studies comparing combination regimens as first-line therapy in patients with indolent NHL showed no significant differences in response rates between bendamustine-containing regimens and standard regimens included in treatment guidelines. Bendamustine has been generally well tolerated in clinical trials and has a low propensity to induce alopecia. Results of ongoing trials will help to clarify the optimal role of bendamustine in indolent NHL. Available data indicate that it may be a particularly useful treatment option as monotherapy in patients with indolent NHL whose disease progressed during or following rituximab-based therapy, many of whom are also refractory to standard chemotherapy regimens.
Plosker
Greg L
GL
Wolters Kluwer Health, Adis, Auckland, New Zealand. demail@adis.co.nz
Carter
Natalie J
NJ
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D018906:Antineoplastic Agents, Alkylating / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride; D002986:Clinical Trials as Topic; D019008:Drug Resistance, Neoplasm; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000503:physiopathology; D018365:Neoplasm, Residual / Q000188:drug therapy*; D009588:Nitrogen Mustard Compounds / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018906:Antineoplastic Agents, Alkylating; D009588:Nitrogen Mustard Compounds; D000069283:Rituximab; D000069461:Bendamustine Hydrochloride