Secondary efficacy subanalysis by histology from the phase III BRIGHT study: First-line bendamustine-rituximab (BR) compared with standard R-CHOP/R-CVP for patients with advanced indolent non-Hodgkin lymphoma (NHL) or mantle cell lymphoma (MCL).

Authors

Ian Flinn

Ian Flinn

Sarah Cannon Research Institute, Nashville, TN

Ian Flinn , Richard H. C. Van Der Jagt , Brad S. Kahl , Peter Wood , Tim E. Hawkins , David MacDonald , Mark Hertzberg , Yiu-Lam Kwan , David Simpson , Michael Craig , Kathryn S. Kolibaba , Samar Issa , Regina Clementi , Doreen M. Hallman , Mihaela C. Munteanu , Ling Chen , John M. Burke

Organizations

Sarah Cannon Research Institute, Nashville, TN, Ottawa Hospital, General Campus, Ottawa, ON, Canada, University of Wisconsin Carbone Cancer Center, Madison, WI, Princess Alexandra Hospital, Woolloongabba, Australia, Auckland Hospital, Auckland, New Zealand, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada, Westmead Hospital, Wentworthville, Australia, Concord Repatriation General Hospital, Concord West, NSW, Australia, North Shore Hospital, Takapuna, New Zealand, Osborn Hematopoietic Malignancy and Transplant Program, West Virginia University, Morgantown, WV, Compass Oncology, Vancouver, WA, Middlemore Hospital, Auckland, New Zealand, Teva Pharmaceuticals, Inc., Frazer, PA, Rocky Mountain Cancer Centers, Aurora, CO

Research Funding

Pharmaceutical/Biotech Company

Background: BR was previously reported to be statistically noninferior to R-CVP/R-CHOP for complete response rate in the treatment of patients with indolent NHL or MCL. Evaluation of time-to-event outcomes is immature. This subanalysis reports response by histology. Methods: Indolent NHL or MCL was histologically confirmed <6 months before study enrollment in patients who were therapy-naïve. Patients were stratified according to predetermined standard treatment (R-CHOP or RECVP) and lymphoma type, then assigned to receive BR (28-day cycles: bendamustine 90 mg/m2 on days 1 and 2, rituximab 375 mg/m2on day 1) or standard treatment (21-day cycles at standard doses) for 6-8 cycles. Responses were assessed by a blinded independent review committee. The primary efficacy measure was noninferiority of BR complete response (CR) rate for evaluable patients with ≥1 postbaseline efficacy assessment. If the noninferiority threshold was met, superiority was assessed. Secondary measures included tolerability. Results: Of 447 patients enrolled in the study, 213 receiving BR and 206 receiving R-CHOP/R-CVP were evaluable with postbaseline data (Table). BR achieved a statistically noninferior CR rate compared with R-CHOP/R-CVP in patients with indolent NHL and MCL. Conclusions: In patients with treatment-naïve indolent NHL and MCL, BR achieved the primary endpoint of noninferior CR rate. Most CR rates were numerically, but not significantly, higher with BR. Small subgroup results should be interpreted with caution. Support: Teva BPP R&D, Inc. Clinical trial information: NCT00877006.

Response rates.
n/N (%) CR
CR + partial response
BR R-CHOP/R-CVP CR ratio [95% CI] BR R-CHOP/R-CVP
Indolent NHL 49/178 (28) 43/174 (25) 1.11 [0.78, 1.59] 173/178 (97) 160/174 (92)
 Follicular 45/148 (30) 37/149 (25) 1.23 [0.85, 1.78] 147/148 (>99) 140/149 (94)
 Lymphoplasmacytic 0/5 1/6 (17) 0.39 [0.02, 7.88] 3/5 (60) 6/6 (100)
 Marginal zone 5/25 (20) 4/17 (24) 0.84 [0.26, 2.66] 23/25 (92) 12/17 (71)
MCL 17/34 (50) 9/33 (27)* 1.76 [0.91, 3.42] 32/34 (94) 28/33 (85)*

* R-CHOP, n = 22.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Lymphoma and Plasma Cell Disorders

Track

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Sub Track

Lymphoma

Clinical Trial Registration Number

NCT00877006

Citation

J Clin Oncol 31, 2013 (suppl; abstr 8537)

DOI

10.1200/jco.2013.31.15_suppl.8537

Abstract #

8537

Poster Bd #

17

Abstract Disclosures