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Evidence Grows for Bendamustine-Rituximab Combination for Lymphoma

TOP - February 2013 VOL 6, NO 1

Several studies presented at the 54th Annual Meeting of the American Society of Hematology (ASH) found that a regimen that combines bendamustine with rituximab (B-R) may result in superior outcomes compared with the current standard of care, rituximab plus cyclophosphamide/doxorubicin/vincristine/prednisone (R-CHOP) or rituximab plus cyclophosphamide/vincristine/prednisone (R-CVP), in patients with non-Hodgkin lymphoma (NHL) and mantle cell lymphoma (MCL).

A subanalysis of the Study Group on Indolent Lymphomas (StiL) NHL 1-2003 study, which indicated a substantial benefit for B-R in a study presented at ASH in 2011, showed that complete responses (CRs) were more frequent with B-R (39.8%) than with R-CHOP/R-CVP (30.0%). Regardless of the quality of response, first-line treatment with B-R resulted in superior progression-free survival (PFS). In patients with CRs, median PFS exceeded the 5-year evaluation point with B-R, compared with 53.7 months for patients receiving standard therapy.1

In a different noninferiority study—the Bendamustine Rituximab Investigational Non-Hodgkin’s Trial (BRIGHT) of 447 patients—treatment with B-R was associated with CR rate that was noninferior to R-CHOP/R-CVP: 31% versus 25%, meeting the primary objective of the study. The CR rate was significantly higher with B-R in the subgroup of patients with MCL, and quality-of-life scores were higher overall with B-R.2

Investigators for both studies noted that the toxicity profiles of these regimens are very different, which thus can help guide treatment selection.

1. Rummel MJ, Niederle N, Maschmeyer G, et al. Subanalysis of the StiL NHL 1-2003 study: achievement of complete response with bendamustine-rituximab (B-R) and CHOP-R in the first-line treatment of indolent and mantle cell lymphomas results in superior survival compared to partial response. Presented at: 54th American Society of Hematology Annual Meeting; December 8-11, 2012; Atlanta, GA. Abstract 2724.
2. Flinn IW, van der Jagt RH, Kahl BS. An open-label, randomized study of bendamustine and rituximab (BR) compared with rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP) or rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in first-line treatment of patients with advanced indolent non-Hodgkin’s lymphoma (NHL) or mantle cell lymphoma (MCL): the Bright study. Presented at: 54th American Society of Hematology Annual Meeting; December 8-11, 2012; Atlanta, GA. Abstract 902.

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