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Antineoplastic Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Another alkylating agent, bendamustine is a bifunctional mechlorethamine related antineoplastic used to treat chronic lymphocytic leukemia, B cell non-Hodgkin lymphoma. Pregnant mice given the drug during organogenesis had an increased frequency of embryonic losses, decreased fetal weight, and birth defects (exencephaly, cleft palate, and spinal deformities) (Manufacturer’s product information).
Nucleic Acids as Therapeutic Targets and Agents
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Bendamustine is administered by intravenous infusion, after which it is extensively metabolized in the liver by cytochrome p450. It has been used both as a sole therapy and in combination with other agents, including etoposide, fludarabine, mitoxantrone, methotrexate, prednisone, rituximab, and vincristine (Figure 5.18). Structure of bendamustine.
Anti-CD20 Monoclonal Antibody Treatment in Follicular Lymphoma and Chronic Lymphocytic Leukemia
Published in Sherry X. Yang, Janet E. Dancey, Handbook of Therapeutic Biomarkers in Cancer, 2021
Bendamustine also became a commonly utilized chemotherapy platform in FL after demonstrating augmented activity with the addition of rituximab (BR) [46, 47]. BR was compared with R-CHOP in a phase III non-inferiority trial in patients with indolent lymphoma. The OR rates were similar among the two arms, but CR was increased in the BR group (39.8% compared with 30.0% in the R-CHOP group). The FL patients treated with BR also exhibited prolonged PFS (not reached) compared with 40.9 months in the R-CHOP group at a median 45-month follow-up, although no difference in OS was observed. Regarding toxicity, the BR group had decreased rates of infection, alopecia, peripheral neuropathy, stomatitis, and hematologic toxicity. These results as well as the confirmatory BRIGHT study established BR as an attractive alternative to R-CHOP and R-CVP [48, 49].
The pharmacological management of hairy cell leukemia
Published in Expert Opinion on Pharmacotherapy, 2020
Jorge Ramos Perez, Farhad Ravandi-Kashani
Bendamustine is a chemotherapeutic agent with major clinical activity in other low-grade lymphoproliferative disorders. It is currently approved for the treatment of CLL and non-Hodgkin Lymphomas [62]. It has mechanistic properties of both alkylating agent and purine nucleoside analog. A pilot study intended to determine the tolerability and to explore the efficacy of bendamustine plus rituximab in multiple relapsed/refractory HCL patients was reported in 2013 [55]. Twelve patients were enrolled in two groups to receive bendamustine at a dose of either 70 mg/m2 or 90 mg/m2, administered IV on days 1 and 2 of a 28-day cycle for 6 cycles, and rituximab 375 mg/m2 administered on days 1 and 15 of each cycle. All patients were previously treated with a median of three courses of purine analog, and eight of them had prior rituximab therapy. The ORR was 100% with 50-67% achieving CR. The median time to respond was similar regardless of the dose of bendamustine received. Fifty percent of all patients achieved negative MRD and at a median follow up of 31 months, none of the patients with CR had relapsed. The most common toxicities observed were cytopenias. All toxicities were reversible and only one patient required a delay in treatment. These results are encouraging in this heavily pre-treated population. A randomized phase II clinical trial of rituximab with either pentostatin or bendamustine for multiply relapsed or refractory hairy cell leukemia is ongoing at NCI (NCT01059786).
Bendamustine treatment of haematological malignancies: significant risks of opportunistic viral, fungal and bacterial infections
Published in Hematology, 2022
Tony K.Y. Wu, Karen H.K. Tang, Yu-Yan Hwang, Thomas S.Y. Chan, Eric Tse, Yok-Lam Kwong
Bendamustine is an alkylating agent and purine analogue hybrid used predominantly in B-cell lymphomas and chronic lymphocytic leukaemia [1], and in selected haematological malignancies, including T-cell lymphoma [2] and myeloma [3]. Despite these diverse applications, bendamustine is primarily used to treat indolent B-cell lymphomas [1]. In comparison with more conventional strategies, including fludarabine-containing regimens, CVP (cyclophosphamide, vincristine, prednisolone) and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone), bendamustine use was associated with a superior overall survival [1]. Because of a relative simplicity of administration, bendamustine has become increasingly popular in the management of indolent B-cell malignancies [1].
Current and emerging treatment options for a patient with a second relapse of Hodgkin’s lymphoma
Published in Expert Review of Hematology, 2018
Avyakta Kallam, James O. Armitage
Phase II study was done to evaluate the efficacy and toxicity of bendamustine in 36 patients with relapsed/refractory HL [15]. Bendamustine was administered on days 1 and 2 of each 28-day cycle for a total of six cycles of treatment. A total of 25 patients were eligible for an allogenic transplant. The ORR for the 36 patients was 53%, demonstrating that bendamustine is a good option for heavily pretreated patients with HL. Thrombocytopenia was the most common toxicity seen with 20% of patients experiencing grade III or IV thrombocytopenia. A retrospective study of 27 patients who had received bendamustine after progression on brentuximab vedotin showed an ORR of 55.5% with 37% obtaining a CR [16].