Bendamustine-Rituximab-Bortezomib Promising in R/R Waldenström Macroglobulinemia

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High rates of PFS found with salvage treatment with BRB regimen in patients with R/R Waldenström macroglobulinemia.
High rates of PFS found with salvage treatment with BRB regimen in patients with R/R Waldenström macroglobulinemia.
The following article features coverage from the American Society of Hematology (ASH) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Undergoing salvage treatment with bendamustine, rituximab, and bortezomib (BRB) for relapsed or refractory (R/R) Waldenström macroglobulinemia (WM) resulted in a high rate of progression-free survival (PFS) at 18 months, according to study results presented at the 60th American Society of Hematology (ASH) Annual Meeting in San Diego, California.

“Moreover, the deep antitumor activity of this regimen is highlighted by the promising rates of both clinical and molecular responses,” researcher Giulia Benevolo, MD, of Citta della Salute e della Scienza Hospital, Turin, Italy, and colleagues reported.

Currently, standard rituximab plus chemotherapy is used as salvage therapy in patients with relapsed or refractory WM; however, 18-month progression-free survival is achieved in only approximately 50% of cases.

This phase 2 study looked at the efficacy of the BRB regimen in this group of patients, and researchers hypothesized an 18-month progression-free survival of at least 65%. This would require a sample of 38 patients followed for at least 24 months.

Patients were treated with rituximab 375 mg/m2 followed by intravenous bendamustine 90 mg/m2, and subcutaneous bortezomib 1.3 mg/m2 for 6 months.

At the time of analysis, 27 patients from 18 centers had completed 6 cycles of therapy. Six patients stopped therapy for toxicity, 2 had died, and 3 completed therapy but were not yet evaluated.

Eighteen-month progression-free survival was 84%. Two patients had progressions and two deaths occurred without evidence of progression.

The intent-to-treat analysis of 35 patients showed an overall response rate of 82.9% with 9% of patients experiencing complete response, 37% very good partial response, 34% partial response, and 3% minimal response.

The most common adverse events of any grade included 34% of patients experienced grade 3/4 neutropenia, with 4 patients discontinuing therapy due to toxicity. Five patients (13%) experienced peripheral nervous system toxicity, with no discontinuations.

Read more of Cancer Therapy Advisor's coverage of the ASH 2018 meeting by visiting the conference page.


  1. Benevolo G, Ferrero S, Andriani A, et al. Clinical and molecular results of the phase II BRB (bendamustine, rituximab and bortezomib) trial of the Fondazione Italiana Linfomi (FIL) for relapsed/refractory Waldenstrom macroglobulinemia patients. Poster presentation at: American Society of Hematology 60th Annual Meeting & Exposition; December 1-4, 2018; San Diego, CA.

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