Experiences with
Bendamustine200 public posts
Acalabrutinib, venetoclax and obinutuzumab in relapsed CLL: Phase 2 CLL2-BAAG trial results from the German CLL Study Group
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Of note is the optional inclusion of Bendamustine for debulking* and the MRD guided protocol [i] "All patients received the MRD-guided triple combination, and 18 received optional debulking with bendamustine prior to induction, which consisted of six 28-day cycles of the triple combination and
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CLL survival times ARE improving, thanks to BTK and BCL-2 inhibitors
Those older chemoimmunotherapy treatments, typically Bendamustine + Rituximab (BR) or Fludarabine + Cyclophosphamide + Rituximab (FCR), selected for tougher to treat sub-clones, which they cause through inducing DNA damage that will hopefully trigger apoptosis [u]if[/u] the TP53 gene isn't mutated or
Median PFS for FCR treated CLL patients with IGHV-M was 14.6 years vs 4.2 years for patients with IGHV-UM. V+O and I+R look to be superior
Prior to the advent of targeted therapies, we only had chemoimmunotherapy treatments, typically BR (bendamustine+rituximab) or a very old drug chlorambucil to offer to most patients needing treatment.
Relative risk for secondary bone marrow cancer within 5 years after initial CLL chemoimmunotherapy treatment (typically BR or FCR)
I can't see any justification for Bendamustine+Rituximab (BR) treatment when targeted therapies are available. You don't see this curative effect with BR.
FDA Approves Zanubrutinib for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphom
Findings from SEQUOIA showed that at a median follow-up of 25.0 months, the median progression-free survival (PFS) was not reached (95% CI, not estimable [NE]–NE) with zanubrutinib vs 33.7 months (95% CI, 28.1-NE) with bendamustine and rituximab (Rituxan; BR) in patients with treatment-naïve CLL/SLL
Zanubrutinib PFS, ORR Is Superior to Ibrutinib for Relapsed/Refractory CLL/SLL
This application was based on earlier findings from an interim analysis of the ALPINE study along with phase 3 findings from the SEQUOIA study (NCT03336333), which showed improvements in PFS compared with bendamustine plus rituximab (Rituxan).
Treatment-naive or relapsed CLL patients will soon have zanubrutinib/Brukinsa as a treatment option in the EU
In these two trials, BRUKINSA demonstrated superior efficacy versus either bendamustine plus rituximab (B+R) or ibrutinib in first-line or R/R CLL, respectively.