Dalhousie University, Halifax, NS, Canada
David MacDonald , Richard van der Jagt , John M. Burke , Brad S. Kahl , Peter Wood , Tim E. Hawkins , Mark Hertzberg , Yiu-Lam Kwan , David Simpson , Michael Craig , Kathryn S. Kolibaba , Samar Issa , Regina Clementi , Doreen M. Hallman , Mihaela C. Munteanu , Ling Chen , Ian Flinn
Background: The BRIGHT study demonstrated that first-line BR was non-inferior to R-CHOP/R-CVP in terms of complete remission rate in indolent NHL and MCL. This is the first detailed analysis of the safety and tolerability of the study regimens. Methods: Patients were preselected for R-CHOP or R-CVP, and then randomized to 6-8 cycles of BR (28-d cycle) or the preselected standard regimen (21-d cycles). BR dosing was bendamustine 90 mg/m2/d as a 30-min infusion on days 1 and 2 plus rituximab 375 mg/m2given before bendamustine on day 1. Colony stimulating factors (CSFs) and antiemetics were given per local standards. Results: In patients preselected for R-CHOP, 103 received BR and 98 R-CHOP. In patients preselected for R-CVP, 118 received BR and 116 R-CVP. For all regimens, ≥ 88% of patients received the planned 6 cycles. Main differences in adverse events (AEs), all grades, are shown in the Table. Incidence of grade 3/4 AEs was 69% for R-CHOP vs 56% BR, and 50% for R-CVP vs 56% BR. Grade 3/4 drug hypersensitivity, neuropathy, and rash were infrequent. Antiemetic use was similar between groups except use of aprepitant as an adjunct to 5-HT3 antagonists was higher with R-CHOP (23% [19% in cycle 1]) than BR (9% [2%]) or R-CVP (3% [2%]). CSF use was higher with R-CHOP (61%) than BR (29%) or R-CVP (27%). Analyses of event prevalence over the treatment period and by region will also be presented. Conclusions: BR, R-CHOP, and R-CVP have significantly distinct AE profiles. More nausea, vomiting, and hypersensitivity occurred with BR while more constipation, neuropathy, and alopecia occurred with RECHOP/R-CVP. Support: Teva BPP R&D, Inc. Clinical trial information: NCT00877006.
Preselected for R-CHOP |
Preselected for R-CVP |
|||
---|---|---|---|---|
BR (n = 103) % |
R-CHOP (n = 98) % |
BR (n = 118) % |
R-CVP (n = 116) % |
|
Nausea | 63 | 58 | 63 | 39 † |
Vomiting | 29 | 13 * | 25 | 13 * |
Constipation | 32 | 40 | 27 | 44 * |
Drug hypersensitivity a | 17 | 6 * | 13 | 3 * |
Infection a | 55 | 57 | 53 | 50 |
Grade ≥3 infection | 12 | 5 | 7 | 7 |
Opportunistic infection a | 10 | 7 | 12 | 9 |
Pneumonia / respiratory infection a | 18 | 14 | 14 | 13 |
Peripheral neuropathy / paresthesia a | 9 | 44 † | 14 | 47 † |
Rash / urticaria a | 20 | 12 | 24 | 16 |
Alopecia | 4 | 51 † | 3 | 21 † |
a From multiple preferred terms. * P <0.05; † P <0.005.
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Abstract Disclosures
2017 ASCO Annual Meeting
First Author: Ian Flinn
2013 ASCO Annual Meeting
First Author: Ian Flinn
2023 ASCO Annual Meeting
First Author: Carrie Ho
2021 ASCO Annual Meeting
First Author: David Belada