Bendamustine Has Activity in Patients with Relapsed, Refractory Hodgkin Lymphoma

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(ChemotherapyAdvisor) – A phase 2 study evaluating the efficacy of bendamustine in patients with relapsed and refractory Hodgkin lymphoma has confirmed its efficacy, with results supporting current and future studies of bendamustine combinations in this population, investigators reported in the Journal of Clinical Oncology online December 17.

Noting limited data exist regarding activity of bendamustine in Hodgkin lymphoma, Alison J. Moskowitz, MD, of Memorial Sloan-Kettering Cancer Center, New York, NY, and colleagues enrolled 36 patients who were ineligible for autologous stem-cell transplantation (ASCT), or for whom this treatment failed. Bendamustine 120mg/m2 was administered as a 30-minute infusion on days 1 and 2 every 28 days with growth factor support (either filgrastim or pegfilgrastim).

The patients were heavily pretreated, including 75% with previous ASCT, 17% with allogenic stem-cell transplantation (alloSCT), 11% with both ASCT and alloSCT, and >50% with more than four prior treatments, Dr. Moskowitz reported. The overall response rate was 53%, including 12 complete responses (33%) and 7 partial responses (19%). Among the 34 evaluable patients, the response rate was 56%.

“Responses were seen in patients with prior refractory disease, prior ASCT, and prior alloSCT; however, no responses were seen in patients who relapsed within 3 months of ASCT,” they stated. Median duration of response was 5 months, and 5 patients (20% of those eligible) proceeded to alloSCT after bendamustine treatment. The most common grade ≥3 adverse events included thrombocytopenia (20%), anemia (14%), and infection (14%).

“With a response rate of 53% in heavily pretreated patients, bendamustine is a good option for patients with relapsed and refractory Hodgkin lymphoma who could proceed to consolidative SCT,” the authors noted. “Studies evaluating bendamustine in combination with other agents are warranted to improve response duration and referral rate to alloSCT.”

Ongoing trials in patients with relapsed and refractory Hodgkin lymphoma include bendamustine plus gemcitabine (NCT01535924) and bendamustine plus lenalidomide (NCT01412307). Other promising agents, such as everolimus and the histone deacetylase inhibitors, panobinostat and entinostat, warrant evaluation either in combination with or as maintenance after bendamustine, they concluded.

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