Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 12/2015

01-12-2015 | Original Article – Clinical Oncology

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

Authors: Elisabeth Stöhr, Frederic Carsten Schmeel, Leonard Christopher Schmeel, Mathias Hänel, Ingo G. H. Schmidt-Wolf, German Refractory Myeloma Study Group

Published in: Journal of Cancer Research and Clinical Oncology | Issue 12/2015

Login to get access

Abstract

Purpose

Treatment options for patients with relapsed and refractory multiple myeloma have improved since the introduction of immune-modulating agents such as lenalidomide and thalidomide. However, almost all patients relapse and suffer from an increasing amount of adverse events due to multiple lines of therapy that eventually lead to a reduced quality of life.

Methods

In this bicentric retrospective analysis, 58 patients who had been treated with either bendamustine monotherapy (62 % of the patients) or combined steroid therapy were included. Further inclusion criteria were at least relapsed disease. Patients had previously been treated with a mean of four lines of therapy (range 1–10). They received a median of three cycles of treatment. Dosage varied from 60 to 300 mg/m2 (median 120 mg/m2) and was administered intravenously on day 1 and 2 of a 28-day cycle.

Results

Observed toxicity was mild and most commonly led to hematological side effects such as thrombopenia and anemia. Response rates were as follows: no complete response, 20 % partial response, 39 % minimal response, 27 % stable disease and 14 % progressive disease. Median overall survival (OS) was 17 months. Median event-free survival was 7 months. Patients who had not received a concomitant steroid had a median OS of 17 months compared to 13 months median OS for patients who had received a concomitant steroid.

Conclusion

Bendamustine monotherapy is an effective treatment option for heavily pre-treated myeloma patients due to its favorable response rate and mild toxicity.
Literature
go back to reference Berenson JR, Yellin O, Bessudo A, Boccia RV, Noga SJ, Gravenor DS et al (2013) Phase I/II trial assessing bendamustine plus bortezomib combination therapy for the treatment of patients with relapsed or refractory multiple myeloma. Br J Haematol 160(3):321–330. doi:10.1111/bjh.12129 CrossRefPubMed Berenson JR, Yellin O, Bessudo A, Boccia RV, Noga SJ, Gravenor DS et al (2013) Phase I/II trial assessing bendamustine plus bortezomib combination therapy for the treatment of patients with relapsed or refractory multiple myeloma. Br J Haematol 160(3):321–330. doi:10.​1111/​bjh.​12129 CrossRefPubMed
go back to reference Lentzsch S, O’Sullivan A, Kennedy RC, Abbas M, Dai L, Pregja SL et al (2012) Combination of bendamustine, lenalidomide, and dexamethasone (BLD) in patients with relapsed or refractory multiple myeloma is feasible and highly effective: results of phase 1/2 open-label, dose escalation study. Blood 119(20):4608–4613. doi:10.1182/blood-2011-12-395715 PubMedCentralCrossRefPubMed Lentzsch S, O’Sullivan A, Kennedy RC, Abbas M, Dai L, Pregja SL et al (2012) Combination of bendamustine, lenalidomide, and dexamethasone (BLD) in patients with relapsed or refractory multiple myeloma is feasible and highly effective: results of phase 1/2 open-label, dose escalation study. Blood 119(20):4608–4613. doi:10.​1182/​blood-2011-12-395715 PubMedCentralCrossRefPubMed
go back to reference Michael M, Bruns I, Bölke E, Zohren F, Czibere A, Safaian NN et al (2010) Bendamustine in patients with relapsed or refractory multiple myeloma. Eur J Med Res 15(1):13–19PubMedCentralCrossRefPubMed Michael M, Bruns I, Bölke E, Zohren F, Czibere A, Safaian NN et al (2010) Bendamustine in patients with relapsed or refractory multiple myeloma. Eur J Med Res 15(1):13–19PubMedCentralCrossRefPubMed
go back to reference Niesvizky R, Richardson PG, Rajkumar SV, Coleman M, Rosiñol L, Sonneveld P et al (2008) The relationship between quality of response and clinical benefit for patients treated on the bortezomib arm of the international, randomized, phase 3 APEX trial in relapsed multiple myeloma. Br J Haematol 143(1):46–53. doi:10.1111/j.1365-2141.2008.07303.x CrossRefPubMed Niesvizky R, Richardson PG, Rajkumar SV, Coleman M, Rosiñol L, Sonneveld P et al (2008) The relationship between quality of response and clinical benefit for patients treated on the bortezomib arm of the international, randomized, phase 3 APEX trial in relapsed multiple myeloma. Br J Haematol 143(1):46–53. doi:10.​1111/​j.​1365-2141.​2008.​07303.​x CrossRefPubMed
go back to reference Offidani M, Corvatta L, Maracci L, Liberati AM, Ballanti S, Attolico I et al (2013) Efficacy and tolerability of bendamustine, bortezomib and dexamethasone in patients with relapsed-refractory multiple myeloma: a phase II study. Blood Cancer J 3(11):e162. doi:10.1038/bcj.2013.58 PubMedCentralCrossRefPubMed Offidani M, Corvatta L, Maracci L, Liberati AM, Ballanti S, Attolico I et al (2013) Efficacy and tolerability of bendamustine, bortezomib and dexamethasone in patients with relapsed-refractory multiple myeloma: a phase II study. Blood Cancer J 3(11):e162. doi:10.​1038/​bcj.​2013.​58 PubMedCentralCrossRefPubMed
go back to reference Pönisch W, Mitrou PS, Merkle K, Herold M, Assmann M, Wilhelm G et al (2006) Treatment of bendamustine and prednisone in patients with newly diagnosed multiple myeloma results in superior complete response rate, prolonged time to treatment failure and improved quality of life compared to treatment with melphalan and prednisone—a randomized phase III study of the East German Study Group of Hematology and Oncology (OSHO). J Cancer Res Clin Oncol 132(4):205–212. doi:10.1007/s00432-005-0074-4 CrossRefPubMed Pönisch W, Mitrou PS, Merkle K, Herold M, Assmann M, Wilhelm G et al (2006) Treatment of bendamustine and prednisone in patients with newly diagnosed multiple myeloma results in superior complete response rate, prolonged time to treatment failure and improved quality of life compared to treatment with melphalan and prednisone—a randomized phase III study of the East German Study Group of Hematology and Oncology (OSHO). J Cancer Res Clin Oncol 132(4):205–212. doi:10.​1007/​s00432-005-0074-4 CrossRefPubMed
go back to reference Pönisch W, Heyn S, Beck J, Wagner I, Mohren M, Hoffmann FA et al (2013) Lenalidomide, bendamustine and prednisolone exhibits a favourable safety and efficacy profile in relapsed or refractory multiple myeloma: final results of a phase 1 clinical trial OSHO-#077. Br J Haematol. doi:10.1111/bjh.12361 PubMed Pönisch W, Heyn S, Beck J, Wagner I, Mohren M, Hoffmann FA et al (2013) Lenalidomide, bendamustine and prednisolone exhibits a favourable safety and efficacy profile in relapsed or refractory multiple myeloma: final results of a phase 1 clinical trial OSHO-#077. Br J Haematol. doi:10.​1111/​bjh.​12361 PubMed
go back to reference Rodon P, Hulin C, Pegourie B, Tiab M, Anglaret B, Benboubker L et al (2015) Phase II study of bendamustine, bortezomib and dexamethasone as second-line treatment for elderly patients with multiple myeloma: the Intergroupe Francophone du Myelome 2009-01 trial. Haematologica 100(2):e56–e59. doi:10.3324/haematol.2014.110890 CrossRefPubMed Rodon P, Hulin C, Pegourie B, Tiab M, Anglaret B, Benboubker L et al (2015) Phase II study of bendamustine, bortezomib and dexamethasone as second-line treatment for elderly patients with multiple myeloma: the Intergroupe Francophone du Myelome 2009-01 trial. Haematologica 100(2):e56–e59. doi:10.​3324/​haematol.​2014.​110890 CrossRefPubMed
Metadata
Title
Bendamustine in heavily pre-treated patients with relapsed or refractory multiple myeloma
Authors
Elisabeth Stöhr
Frederic Carsten Schmeel
Leonard Christopher Schmeel
Mathias Hänel
Ingo G. H. Schmidt-Wolf
German Refractory Myeloma Study Group
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 12/2015
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-015-2014-2

Other articles of this Issue 12/2015

Journal of Cancer Research and Clinical Oncology 12/2015 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.