A multicenter phase II study of bendamustine with rituximab in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).

Authors

null

Michinori Ogura

Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, Aichi, Japan

Michinori Ogura , Kiyoshi Ando , Nozomi Niitsu , Seok Jin Kim , Ken Ohmachi , Naoki Takahashi , Toshiki Uchida , Naoto Takahashi , Naokuni Uike , Hyeon Seok Eom , Yee Soo Chae , Takashi Terauchi , Ukihide Tateishi , Mitsuaki Tatsumi , Won Seog Kim , Cheolwon Suh , Kensei Tobinai

Organizations

Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, Aichi, Japan, Department of Hematology and Oncology, Tokai University Hospital, Kanagawa, Japan, Department of Hematology, Saitama Medical University International Medical Center, Saitama, Japan, Hematology-Oncology, Samsung Medical Center, Seoul, South Korea, Department of Hematology, Akita University Hospital, Akita, Japan, Hematology, National Kyusyu Cancer Center, Fukuoka, Japan, Hematology-Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, Gyeonggi-do, South Korea, Hematology-Oncology Department, Kyungpook National University Hospital, Daegu, South Korea, Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan, Department of Radiology, Yokohama City University Hospital, Kanagawa, Japan, Diagnostic and Interventional Radiology, Osaka University Hospital, Osaka, Japan, Department of Oncology, Asan Medical Center, Seoul, South Korea, Department of Hematology, and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

Research Funding

Pharmaceutical/Biotech Company
Background: Effective salvage therapies are needed in patients (pts) with relapsed/refractory DLBCL after R-CHOP. Therapy with bendamustine plus rituximab (B-R) was well tolerated and effective in the preceding phase I study in relapsed/refractory aggressive B-cell non-Hodgkin lymphoma, including DLBCL. This phase II study assessed the efficacy and safety of B-R in pts with relapsed/refractory DLBCL. Methods: Pts with histologically confirmed DLBCL (excluding transformed disease) and 1-3 prior therapies received rituximab 375 mg/m2 IV on day 1 and bendamustine 120 mg/m2 IV on days 2 and 3 of each 21-day cycle, for up to 6 cycles. Recovery of neutrophil count to ≥1,000/mm3 and platelet count to ≥75,000/mm3 were required prior to the start of each cycle; treatment delays >2 weeks resulted in discontinuation. The primary endpoint was overall response rate (ORR); secondary endpoints included complete response (CR) rate, progression-free survival (PFS), and safety. Results: A total of 63 pts were enrolled; data from 59 pts were available. Median age was 67 (range, 36-75) years with 37 pts over 65 years. The majority of pts (64.4%) had 1 prior therapy; 57 pts (96.6%) were previously treated with rituximab-containing combination chemotherapy and 8 (13.6%) had prior auto-PBSCT. Pts received a median of 4 (range, 1-6) treatment cycles. Sixteen (27.1%) pts completed 6 treatment cycles; most common reasons for early discontinuation were disease progression (n=15) and failure to meet criteria to start the next cycle (n=13). Among 59 pts evaluable for response, ORR was 62.7% with a 37.3% CR rate. The median PFS was 200 days (95% CI, 109-410). Most common grade 3/4 adverse events (AEs) included CD4 lymphocytes decreased (66.1%), neutropenia (54.2%), and thrombocytopenia (10.2%). Four (6.8%) pts discontinued due to serious AEs (cytomegalovirus infection, infection, pneumonia, and pneumonia/respiratory failure). Conclusions: B-R demonstrated promising activity in pts with relapsed/refractory DLBCL. Toxicity was primarily hematologic and generally manageable. These results suggest that B-R is a promising salvage regimen for pts with relapsed/refractory DLBCL after R-CHOP.

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Abstract Details

Meeting

2012 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

NCT01118845

Citation

J Clin Oncol 30, 2012 (suppl; abstr 8023)

DOI

10.1200/jco.2012.30.15_suppl.8023

Abstract #

8023

Poster Bd #

3

Abstract Disclosures

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