Peripheral T-cell lymphoma: bendamustine combo delivers high, durable remission

  • Park BB & al.
  • Leuk Lymphoma
  • 6 Jun 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Combination bendamustine, carboplatin, and dexamethasone (BCD) delivered high, durable rates of complete remission in patients with relapsed/refractory peripheral T-cell lymphomas (R/R PTCL).

Why this matters

  • High-dose chemotherapy and autologous stem cell transplant (ASCT) is an acceptable salvage strategy in eligible patients with PTCL; however, prognosis is poor in the 60%-70% of patients who are ineligible for ASCT resulting from disease progression.

Study design

  • Phase 2 BENCART study of BCD in 28 patients with R/R PTCL.
  • Patients in complete or partial remission (CR/PR) with 2 courses of BCD were eligible for ASCT; the remaining patients could proceed to ASCT after 4 cycles of BCD, or continue to 6 BCD cycles.
  • Funding: None disclosed.

Key results

  • Objective response after 2 cycles of BCD (R2):
    • 54%: 19% CR; 35% PR.
  • Median duration of response after R2: 5.3 (range, 0.4-21.9) months.
  • Objective response after completion of planned treatment (Rmax):
    • 54%: 29% CR; 25% PR.
  • Median PFS:
    • 4.4 (95% CI, 2.8-6.0) months overall.
    • 20.2 (range, 6.3-20.5) months with BCD followed by ASCT.
    • 12.4 months in patients with angioimmunoblastic T-cell lymphoma (AITL).
  • Grade 3-4 toxicities (expressed as percentage of 85 cycles) included thrombocytopenia (39%) and neutropenia (18%).

Limitations

  • Single-group design.

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