Diego Villa, MD, MPH, clinical associate professor in the Division of Medical Oncology of the Department of Medicine at The University of British Columbia, discusses the rationale for a retrospective analysis evaluating bendamustine plus rituximab(Rituxan; BR) as induction therapy in patients with mantle cell lymphoma (MCL).

The rationale for a retrospective analysis conducted at The University of British Columbia came from the phase 3 STiL-1 trial, in which the combination demonstrated excellent response rates and progression-free survival compared with the previous standard, rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), says Villa.

However, it is important to note that STiL-1 was done in transplant-ineligible patients. The question of whether to use BR in transplant-eligible patients was still unknown. Other advantages to BR include that it does not cause alopecia or severe nausea, vomiting, or peripheral neuropathy associated with R-CHOP, concludes Villa.

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Diego Villa, MD, MPH, discusses the rationale for a retrospective analysis evaluating bendamustine plus rituximab as induction therapy in patients with mantle cell lymphoma.

Dr. Villa on Rationale for Examining BR as Induction Therapy in Transplant-Eligible MCL

Diego Villa, MD, MPH, clinical associate professor, Division of Medical Oncology, Department of Medicine, The University of British Columbia, discusses the use of bendamustine and rituximab (Rituxan) as induction therapy in mantle cell lymphoma (MCL).

Results from a retrospective analysis conducted at The University of British Columbia showed that BR is a reasonable frontline therapy for patients with MCL, irrespective of transplant eligibility. However, the results need to be further evaluated in a randomized prospective study, says Villa.

To that end, the phase II ECOG-ACRIN 4181 trial is evaluating BR as a backbone and testing the addition of cytarabine and/or acalabrutinib (Calquence) to the chemotherapy backbone, concludes Villa.

Dr. Villa on the Use of BR as Induction Therapy in MCL

Diego Villa, MD, MPH, clinical associate professor, Division of Medical Oncology, Department of Medicine, The University of British Columbia, discusses the findings of a retrospective analysis looking at bendamustine plus rituximab (Rituxan; BR) in mantle cell lymphoma (MCL).

The retrospective analysis reflects the The University of British Columbia’s experience with treating patients with BR over the past 6 years, Villa explains. In 2013, the institution made a decision to treat all patients with MCL with upfront BR regardless of transplant-eligibility status, says Villa.

The analysis showed an overall response rate of 87% and a complete response rate of 54%. There was no difference in response rates between patients over the age of 65 years or under the age of 65 years, concludes Villa.

Diego Villa, MD, MPH, discusses the findings of a retrospective analysis looking at bendamustine plus rituximab in mantle cell lymphoma.

Dr. Villa on Retrospective Data of Bendamustine/Rituximab in MCL

Diego Villa, MD, MPH, clinical associate professor, Division of Medical Oncology, Department of Medicine, The University of British Columbia, discusses the efficacy of induction therapy with bendamustine plus rituximab (Rituxan) in mantle cell lymphoma (MCL).

According to data from a retrospective analysis of patients with newly diagnosed MCL, treatment with BR was found to be an effective regimen compared with standard R-CHOP in transplant-eligible and -ineligible patients.

Notably, 12% of patients developed progressive disease on BR, or within 3 months of completing BR. These patients had a number of high-risk features, including aggressive biology characterized by blastoid or pleomorphic histology and elevated Ki-67, explains Villa. As such, patients with highly proliferative MCL may not be optimal candidates for BR induction and thus, should receive alternative therapy, concludes Villa.

Dr. Villa on the Efficacy of Induction Therapy With BR in MCL

Diego Villa, MD, MPH, clinical associate professor, Division of Medical Oncology, Department of Medicine, The University of British Columbia, discusses a retrospective analysis of bendamustine and rituximab (Rituxan; BR) as induction therapy in patients with transplant-eligible and -ineligible mantle cell lymphoma (MCL).

The study suggests that BR is an effective induction regimen in transplant-eligible and -ineligible patients with MCL, explains Villa. Results were in line with data from the phase III STiL NHL-1 and BRIGHT trials that showed improved progression-free survival with BR compared with standard R-CHOP.

In the analysis, the 3-year rate of PFS with BR was 62.8% (95% CI, 62.4-63.6). Although patients whoreceived R-CVP were included in the analysis, the trend toward improved overall survival favored the use of BR compared with R-CHOP in transplant-ineligible patients.

Among the 89 patients ≤65 years of age who received BR, 67% underwent autologous stem cell transplant (ASCT). BR was associated with a numerical improvement in PFS versus R-CHOP in this group of patients. However, investigators could not claim statistical significance.  

These results support the use of BR in transplant-ineligible patients with MCL. In transplant-eligible patients, BR is can be considered reasonable induction regimen, concludes Villa.

Diego Villa, MD, MPH, discusses a retrospective analysis of bendamustine and rituximab as induction therapy in patients with transplant-eligible and -ineligible mantle cell lymphoma.

Diego Villa, MD, MPH

Articles

Dr. Villa on Rationale for Examining BR as Induction Therapy in Transplant-Eligible MCL

Dr. Villa on the Use of BR as Induction Therapy in MCL

Dr. Villa on Retrospective Data of Bendamustine/Rituximab in MCL

Dr. Villa on the Efficacy of Induction Therapy With BR in MCL

Dr. Villa on Induction Therapy With Bendamustine/Rituximab in MCL