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- Title
MM-146: A Real-World Study of Bendamustine Therapy in a Very Heavily Pre-Treated Population of Multiple Myeloma Patients.
- Authors
Bird, Sarah; Panopoulou, Akaterina; Kaiser, Martin; Boyd, Kevin; Pawlyn, Charlotte
- Abstract
Bendamustine is an alkylating agent with activity against multiple myeloma (MM), and in UK clinical practice, its use is predominately limited to patients who have no other therapeutic options. Assessment of efficacy and toxicity of bendamustine in the real-world setting. Retrospective case-review study including patients commenced on bendamustine Jan. 2016–Jan. 2021 (follow-up until May 2021). A UK tertiary MM center. Twenty-nine patients received bendamustine and corticosteroids, 14 in combination with thalidomide, with a median of 5 prior lines of therapy. Cytogenetic data were available in 19; 95% (18/19) had high-risk-disease at their most recent assessment prior to commencing bendamustine. Bendamustine was given at 60 mg/m2 D1,2; dexamethasone/methylprednisolone weekly; thalidomide 50–200mg daily (28-day cycle). Overall response rate (ORR, ≥partial response, PR), clinical benefit rate (CBR, ≥minimal response, MR), progression-free survival (PFS), overall survival (OS), and toxicity. The median PFS of the cohort was 1.8 months (median follow-up 13 months), and the OS was 4.8 months. Of the 29 patients, 23 were assessable for response (4 completed <1 cycle, 2 had a secretory disease). The ORR was 26% (6/23, all PR), and the CBR was 39% (9/23). Achievement of ≥PR was associated with longer PFS and OS (median PFS 5.3 months vs 1.8 months, p=0.10; OS 14 months vs 4.1 months, p=0.15). Toxicity assessment was performed in the whole cohort. Twenty-eight percent (8/29) had received ≥5 cycles at time of data cut-off and 3 remain on treatment. The reason for stopping therapy was progression in 65% (17/26) and death in 23% (6/26). One patient stopped treatment due to significant cytopenias, 1 due to frailty, and 1 because bendamustine had been used as a bridge to alternative therapy. Thirty-four percent (10/29) only completed ≤1 cycle of therapy, 3 died, 6 progressed, and 1 had severe cytopenias. Fifty-five percent (16/29) required transfusion of platelets and/or red blood cells during their treatment. In this very heavily pre-treated population, bendamustine was associated with an ORR of 26%, and the overall PFS and OS were short at 1.8 and 4.8 months, respectively. However, achieving ≥PR was associated with a longer PFS and OS (5.3 and 14 months, respectively), suggesting bendamustine may provide a therapeutic option for a subgroup of patients when no others are available.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2021, Vol 21, pS424
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/S2152-2650(21)01949-2