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First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial

The incidence of aggressive B-cell lymphomas increases with age, but for elderly or frail patients not eligible for doxorubicin-containing treatment standard therapy remains to be defined. In this prospective, multicenter, phase-2 B-R-ENDA trial, we investigated the feasibility, toxicity, and effica...

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Autores principales: Braulke, Friederike, Zettl, Florian, Ziepert, Marita, Viardot, Andreas, Kahl, Christoph, Prange-Krex, Gabriele, Korfel, Agnieszka, Dreyling, Martin, Bott, Alexander, Wedding, Ulrich, Reichert, Dietmar, de Wit, Maike, Hartmann, Frank, Poeschel, Viola, Schmitz, Norbert, Witzens-Harig, Mathias, Klapper, Wolfram, Rosenwald, Andreas, Wulf, Gerald, Altmann, Bettina, Trümper, Lorenz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722574/
https://www.ncbi.nlm.nih.gov/pubmed/36479544
http://dx.doi.org/10.1097/HS9.0000000000000808
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author Braulke, Friederike
Zettl, Florian
Ziepert, Marita
Viardot, Andreas
Kahl, Christoph
Prange-Krex, Gabriele
Korfel, Agnieszka
Dreyling, Martin
Bott, Alexander
Wedding, Ulrich
Reichert, Dietmar
de Wit, Maike
Hartmann, Frank
Poeschel, Viola
Schmitz, Norbert
Witzens-Harig, Mathias
Klapper, Wolfram
Rosenwald, Andreas
Wulf, Gerald
Altmann, Bettina
Trümper, Lorenz
author_facet Braulke, Friederike
Zettl, Florian
Ziepert, Marita
Viardot, Andreas
Kahl, Christoph
Prange-Krex, Gabriele
Korfel, Agnieszka
Dreyling, Martin
Bott, Alexander
Wedding, Ulrich
Reichert, Dietmar
de Wit, Maike
Hartmann, Frank
Poeschel, Viola
Schmitz, Norbert
Witzens-Harig, Mathias
Klapper, Wolfram
Rosenwald, Andreas
Wulf, Gerald
Altmann, Bettina
Trümper, Lorenz
author_sort Braulke, Friederike
collection PubMed
description The incidence of aggressive B-cell lymphomas increases with age, but for elderly or frail patients not eligible for doxorubicin-containing treatment standard therapy remains to be defined. In this prospective, multicenter, phase-2 B-R-ENDA trial, we investigated the feasibility, toxicity, and efficacy of 8 cycles rituximab combined with 6 cycles bendamustine (BR) in elderly or frail aggressive B-cell lymphoma patients: 39 patients aged >80 years and 29 patients aged 61–80 years with elevated Cumulative Illness Rating Scalescore >6 were included. Progression-free survival (PFS) and overall survival (OS) at 2 years were 45% (95% confidence interval [CI], 28%-61%) and 46% (28%-63%) for the patients age >80, as well 32% (13%-51%) and 37% (17%-57%) for frail patients age 64–80, respectively. In a preplanned retrospective analysis, we found no significant differences in PFS and OS comparing the outcome of the 39 patients age >80 years with 40 patients aged 76–80 years treated with 6xR-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) and 2 x rituximab in the RICOVER-60 trial (DSHNHL 1999-1, NCT00052936, EU-20243), yet we detected lower rates of infections and treatment-related deaths in the BR-treated patients. We demonstrate that older and frail patients with aggressive B-cell lymphoma who are not able to receive standard CHOP-based therapy can benefit from anthracycline-free therapy as a feasible and effective therapeutic option.
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spelling pubmed-97225742022-12-06 First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial Braulke, Friederike Zettl, Florian Ziepert, Marita Viardot, Andreas Kahl, Christoph Prange-Krex, Gabriele Korfel, Agnieszka Dreyling, Martin Bott, Alexander Wedding, Ulrich Reichert, Dietmar de Wit, Maike Hartmann, Frank Poeschel, Viola Schmitz, Norbert Witzens-Harig, Mathias Klapper, Wolfram Rosenwald, Andreas Wulf, Gerald Altmann, Bettina Trümper, Lorenz Hemasphere Article The incidence of aggressive B-cell lymphomas increases with age, but for elderly or frail patients not eligible for doxorubicin-containing treatment standard therapy remains to be defined. In this prospective, multicenter, phase-2 B-R-ENDA trial, we investigated the feasibility, toxicity, and efficacy of 8 cycles rituximab combined with 6 cycles bendamustine (BR) in elderly or frail aggressive B-cell lymphoma patients: 39 patients aged >80 years and 29 patients aged 61–80 years with elevated Cumulative Illness Rating Scalescore >6 were included. Progression-free survival (PFS) and overall survival (OS) at 2 years were 45% (95% confidence interval [CI], 28%-61%) and 46% (28%-63%) for the patients age >80, as well 32% (13%-51%) and 37% (17%-57%) for frail patients age 64–80, respectively. In a preplanned retrospective analysis, we found no significant differences in PFS and OS comparing the outcome of the 39 patients age >80 years with 40 patients aged 76–80 years treated with 6xR-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) and 2 x rituximab in the RICOVER-60 trial (DSHNHL 1999-1, NCT00052936, EU-20243), yet we detected lower rates of infections and treatment-related deaths in the BR-treated patients. We demonstrate that older and frail patients with aggressive B-cell lymphoma who are not able to receive standard CHOP-based therapy can benefit from anthracycline-free therapy as a feasible and effective therapeutic option. Lippincott Williams & Wilkins 2022-12-01 /pmc/articles/PMC9722574/ /pubmed/36479544 http://dx.doi.org/10.1097/HS9.0000000000000808 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Braulke, Friederike
Zettl, Florian
Ziepert, Marita
Viardot, Andreas
Kahl, Christoph
Prange-Krex, Gabriele
Korfel, Agnieszka
Dreyling, Martin
Bott, Alexander
Wedding, Ulrich
Reichert, Dietmar
de Wit, Maike
Hartmann, Frank
Poeschel, Viola
Schmitz, Norbert
Witzens-Harig, Mathias
Klapper, Wolfram
Rosenwald, Andreas
Wulf, Gerald
Altmann, Bettina
Trümper, Lorenz
First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial
title First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial
title_full First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial
title_fullStr First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial
title_full_unstemmed First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial
title_short First-line Treatment With Bendamustine and Rituximab for Old and Frail Patients With Aggressive Lymphoma: Results of the B-R-ENDA Trial
title_sort first-line treatment with bendamustine and rituximab for old and frail patients with aggressive lymphoma: results of the b-r-enda trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722574/
https://www.ncbi.nlm.nih.gov/pubmed/36479544
http://dx.doi.org/10.1097/HS9.0000000000000808
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