Bendamustine, bortezomib and rituximab produces durable complete remissions in patients with previously untreated, low grade lymphoma

Br J Haematol. 2018 Feb;180(3):365-373. doi: 10.1111/bjh.15044. Epub 2017 Nov 28.

Abstract

This Phase II trial evaluated the efficacy of bendamustine, bortezomib and rituximab in patients with previously untreated low-grade lymphoma. Eligible patients had low grade lymphoma with no previous systemic disease treatment. Treatment for all patients was given in 28-day cycles for a maximum of 6 cycles. Patients received rituximab 375 mg/m2 intravenously (IV) on days 1, 8 and 15 of cycle 1 and day 1 of cycles 2-6; bendamustine 90 mg/m2 IV on days 1 and 2; and bortezomib 1·6 mg/m2 IV on days 1, 8 and 15. Patients were permitted to begin maintenance treatment with rituximab 6 months after completion of study treatment and after 6-month follow-up assessments had been conducted. Fifty-four eligible patients were enrolled. The most common grade 3/4 toxicities were leucopenia (28%), neutropenia (30%) and lymphopenia (17%). There were no treatment-related deaths and 1 unrelated death on study (embolic stroke). The overall response rate was 94% for all patients. The median follow-up was 54 months. Kaplan-Meier estimates of progression-free survival and overall survival at 36 months were 75% and 88%, respectively. The treatment regimen was well tolerated and produced high response rates. Further study of this regimen in patients with previously untreated lymphoma is warranted.

Keywords: bendamustine; bortezomib; front-line treatment; low grade lymphoma; rituximab.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bendamustine Hydrochloride / administration & dosage
  • Bortezomib / administration & dosage
  • Female
  • Humans
  • Lymphoma / drug therapy*
  • Lymphoma / mortality
  • Lymphoma / pathology*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Remission Induction
  • Rituximab / administration & dosage
  • Survival Analysis
  • Treatment Outcome

Substances

  • Rituximab
  • Bortezomib
  • Bendamustine Hydrochloride