Bendamustine in heavily pre-treated patients with relapsed or refractory multiple myeloma

Stöhr, Elisabeth; Schmeel, Frederic Carsten; Schmeel, Leonard Christopher; Hänel, Mathias; Schmidt‐Wolf, Ingo G.H.

doi:10.1007/s00432-015-2014-2

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…Recently, an Italian study also reported an ORR of only 29% and a median OS of 7.3 months following various bendamustine-containing salvage treatments in an unselected patient population that more accurately reflected patients encountered in clinical practice [ 18 ]. Although another retrospective study reported a better outcome with an ORR of 59% and a median OS of 17 months, the patient characteristics in that study were different to those in other studies, including ours, in terms of previous treatments and the percentage of patients refractory to their last treatment [ 19 ].…”

Section: Discussioncontrasting

confidence: 57%

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

et al. 2016

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BackgroundBendamustine may be a potential treatment option for patients with myeloma, but little is known about the utility of bendamustine as a salvage treatment, especially in Asian patients.MethodsWe performed a multicenter retrospective study of patients with relapsed or refractory myeloma who received bendamustine and prednisone.ResultsThe records of 65 heavily pre-treated patients, who had undergone bortezomib and lenalidomide treatment (median number of previous treatments: 5), were analyzed. The median time from diagnosis to bendamustine treatment was 3.8 years, and the median patient age was 63 years (range, 38‒77 yr). The responses to the last treatment before bendamustine were refractory disease (N=52, 80%) or disease progression from partial response (N=13, 20%). Twenty-three patients responded to the treatment, with an overall response rate of 35% (23/65), and the median number of bendamustine treatment cycles was two (range, 1‒5 cycles). The median overall survival after bendamustine treatment was 5.5 months and the overall survival rate in responders to bendamustine was significantly better than that in non-responders (P=0.036).ConclusionBendamustine may be a potential salvage treatment to extend survival in a select group of heavily pre-treated patients with relapsed or refractory myeloma.

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Section: Discussioncontrasting

confidence: 57%

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

et al. 2016

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“…Median PFS and OS for the entire cohort were 9.3 and 12.4 months, respectively. An ORR of 59% was reported by Stöhr et al [ 16 ] in heavily treated RRMM patients with a median OS of 17 months and an EFS of 7 months. Recently, Musto et al [ 17 ] published results on 78 MM patients, most of whom were refractory to IMiDs and bortezomib.…”

Section: Discussionmentioning

confidence: 75%

Clinical Outcomes Related to the Use of Bendamustine Therapy for Multiple Myeloma Patients Relapsed-Refractory to IMiDs and Proteasome Inhibitors

Ff¹,

Akkoç²,

Salihoğlu³

et al. 2017

Tjh

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Objective:Multiple myeloma patients who are relapsed or refractory to both proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs) have been reported to have poor outcomes. Bendamustine has been reported to have an antitumor effect in newly diagnosed as well as relapsed/refractory multiple myeloma (RRMM). The aim of this retrospective study was to evaluate the efficacy of bendamustine therapy in heavily pretreated MM patients who were refractory to PIs and IMiDs.Materials and Methods:Nineteen RRMM patients treated either with bendamustine and steroids (n=13) or a combination of bendamustine with novel drugs (n=6) were included. The median number of previous treatment lines was 5 (minimum-maximum: 3-8) and median time from diagnosis was 6 years (minimum-maximum: 1-16). All of the patients were resistant to at least one of the IMiDs and one of the PIs. Bendamustine was given at doses ranging from 90 mg/m2 to 120 mg/m2 on days 1 and 2 of 28-day cycles.Results:A median of 2 (minimum-maximum: 1-8) treatment cycles was administered per patient. The toxicity of bendamustine was mild and mostly of hematological origin. No complete remission was achieved. There was partial remission and stable disease in 21% and 11% of the patients, respectively. Sixty-eight percent of patients had progressive disease. The median progression-free survival and overall survival was 2 and 4 months, respectively.Conclusion:Bendamustine therapy was well tolerated but showed limited anti-myeloma activity in heavily pretreated patients who were refractory to IMiDs and PIs.

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“…In one of the published studies the response rate was 20% (partial response or better) with no complete responses, further 39% of patients had a minimal response, the median event-free survival (EFS) was 7 months, and the median OS was 17 months. Interestingly, patients who received a concomitant steroid had shorter OS (13 months) [ 6 ]. In another study with RRMM patients who previously received alkylators, steroids, IMiDs and bortezomib, the ORR (PR or better) was 30%, including 2% CR, the median PFS was 9.3 months, and the median OS was 12.4 months [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding safety profile, in most reports, bendamustine-based therapies were well-tolerated, and most adverse events were hematological [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Non-hematological adverse events were either associated with hematological complications, such as infections due to neutropenia, or related to other drugs, such as hyperglycemia due to steroids [ 16 ] or neuropathy due to bortezomib [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, bendamustine is also widely used in patients with RRMM, both as monotherapy and in combination with one or two other myeloma-active agents. There are numerous studies reporting on the efficacy and safety of bendamustine in a patient setting: response rates usually ranged from 20 to 30% for monotherapy [ 6 , 7 ] to 35% for a combination of bendamustine with steroids [ 8 ] and more than 80% for triple-drug combinations, including bendamustine [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Drugs that were used in combination with bendamustine are steroids and thalidomide [ 9 , 10 , 11 , 12 ], lenalidomide [ 13 , 14 , 15 , 16 ] or bortezomib [ 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group

Grząśko

Charliński

Morawska

et al. 2021

JCM

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Multiple myeloma (MM) is an incurable disease and patients become refractory to the treatment in the course of the disease. Bendamustine-based regimens containing steroids and other agents are among the therapeutic options offered to MM patients. Here, we investigated the safety and the efficacy of bendamustine used in patients with refractory/relapsed MM (RRMM). The patients were treated with bendamustine and steroids (n = 52) or bendamustine, steroids and immunomodulatory agents or proteasome inhibitors (n = 53). Response rates, progression-free survival (PFS), overall survival (OS) and frequency of adverse events were compared between both study groups. Most efficacy measurements were better in patients treated with three-drug regimens: overall response rate (55% versus 37%, p = 0.062), median PFS (9 months versus 4 months, p < 0.001), median OS survival (18 months versus 12 months, p = 0.679). The benefit from combining bendamustine and steroids with an additional agent was found in subgroups previously treated with both lenalidmide and bortezomib, with stem cell transplant and with more than two previous therapy lines. Toxicity was similar in both study groups and bendamustine-based therapies were generally well-tolerated. Our study suggests that bendamustine may be an effective treatment for patients with RRMM. Three-drug regimens containing bendamustine, steroids and novel agents produced better outcomes and had acceptable toxicity. The efficacy of bendamustine combined with steroids was limited.

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Bendamustine in heavily pre-treated patients with relapsed or refractory multiple myeloma

Abstract: Bendamustine monotherapy is an effective treatment option for heavily pre-treated myeloma patients due to its favorable response rate and mild toxicity.

Cited by 7 publications

References 13 publications

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

Clinical Outcomes Related to the Use of Bendamustine Therapy for Multiple Myeloma Patients Relapsed-Refractory to IMiDs and Proteasome Inhibitors

Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group

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