title: Safety and efficacy of single-agent bendamustine after failure of brentuximab vedotin in patients with relapsed or refractory hodgkin's lymphoma: experience with 27 patients.
abstract: BACKGROUND
  The optimal treatment of patients with heavily pretreated Hodgkin's lymphoma is controversial. Brentuximab vedotin is an active single agent in this context. Also, bendamustine can be regarded as a safe and effective alternative for patients with relapse after autologous transplantation and as an interesting cytoreductive strategy before allogeneic transplantation.
  
  
  METHODS
  An observational, multicenter, retrospective study is reported of single-agent bendamustine in 27 heavily pretreated patients with relapsed or refractory Hodgkin's lymphoma, who had all received brentuximab vedotin as their last treatment and who showed disease progression, refractory disease, or early relapse. The primary study endpoint was the objective response rate, and the secondary endpoint was the safety of the bendamustine regimen.
  
  
  RESULTS
  The overall response rate was 55.5%, with 10 of 27 patients (37.0%) obtaining a complete response. In comparison, the overall response rate previously observed with brentuximab vedotin in the same subset of patients was much lower (18.5%). Among the 10 patients with a complete response after bendamustine, only 1 had had a complete response to brentuximab, with 2 having a partial response and 7 stable or progressive disease. With a median duration of response of 8 months, all these patients had maintained a continuous response at the last follow-up examination. The treatment was well tolerated, with rather infrequent adverse events and transient and manageable toxicities.
  
  
  CONCLUSIONS
  Albeit with the limits of an observational retrospective study, these data indicate that bendamustine shows its efficacy in patients already treated with brentuximab vedotin, regardless of their previously obtained response and without any significant toxicity.
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli," "Sant'Orsola-Malpighi" University Hospital, Bologna, Italy. Electronic address: pierluigi.zinzani@unibo.it.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.affiliation: Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino," Turin, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
authors.affiliation: Medical Oncology Unit 2, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale Tumori," Milan, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Viviani
authors.affiliation: Division of Hematology, Fondazione IRCCS "Istituto Nazionale Tumori," Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.affiliation: Division of Hematology and Bone Marrow Transplant, "Vittorio Emanuele" University Hospital, Catania, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Motta
authors.affiliation: Hematology Unit, Department of Oncology and Hematology, "Santa Maria delle Croci" Hospital, Ravenna, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Tani
authors.affiliation: Division of Hematology, IRCCS "Casa Sollievo della Sofferenza," San Giovanni Rotondo, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cascavilla
authors.affiliation: Institute of Hematology, "Università Cattolica del Sacro Cuore," Rome, Italy.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hohaus
authors.affiliation: Department of Oncology and Advanced Technologies, IRCCS "Arcispedale Santa Maria Nuova," Reggio Emilia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Merli
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli," "Sant'Orsola-Malpighi" University Hospital, Bologna, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Argnani
authors.affiliation: Institute of Hematology "L. e A. Seràgnoli," "Sant'Orsola-Malpighi" University Hospital, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Broccoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D000079963:Brentuximab Vedotin; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D018796:Immunoconjugates; D000079963:Brentuximab Vedotin; D000069461:Bendamustine Hydrochloride
keywords: Bendamustine; Brentuximab vedotin; Hodgkin's lymphoma; Refractory; Relapsed