March 8, 2009

Treanda® Less Toxic than CHOP Chemotherapy for Non-Hodgkin’s Lymphoma


Treanda® Less Toxic than CHOP Chemotherapy for Non-Hodgkin’s Lymphoma

According to the results of a study presented at the 50th annual meeting of the American Society of Hematology, initial treatment of non-Hodgkin’s lymphoma with Treanda® (bendamustine) plus Rituxan® (rituximab) is at least as effective as treatment with CHOP chemotherapy plus Rituxan and has fewer side effects.

Non-Hodgkin’s lymphoma is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. The main cells in the lymph system are lymphocytes, which exist in two forms: B and T-cells. Each of these cells has a specific function in fighting infection.

NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows; both are determined by the cells’ appearance under a microscope.

Chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus Rituxan is one of the commonly used treatment approaches for NHL. Researchers continue to search for alternative approaches to treatment, however, in an effort to maintain or improve effectiveness while reducing side effects.

Treanda is a chemotherapy agent that has been approved for the treatment of indolent (slow-growing) B-cell non-Hodgkin’s lymphoma that has progressed either during therapy or within six months of therapy including Rituxan as well as for chronic lymphocytic leukemia (CLL).

To explore the use of Treanda in the initial treatment of NHL, researchers conducted a Phase III clinical trial among patients with follicular, indolent, or mantle cell lymphomas. Study participants were assigned to receive treatment with either CHOP plus Rituxan or Treanda plus Rituxan.

This study has not yet been completed, but preliminary results were available for more than 400 patients.

  • There was a suggestion that patients treated with Treanda had better progression-free survival than patients treated with CHOP, although this result did not meet the criteria for statistical significance, suggesting that it could have occurred by chance alone. It is possible to conclude, however, that Treanda is at least as effective as CHOP.
  • Side effects such as low white blood cell count and hair loss were less common among patients treated with Treanda than among patients treated with CHOP.

These results suggest that Treanda is at least as effective as CHOP for patients with certain types of non-Hodgkin’s lymphoma and carries a lower risk of side effects. This study may help pave the way toward Treanda becoming a standard part of the initial treatment of NHL.

Reference: Rummel MJ, von Gruenhagen U, Niederle N et al. Bendamustine plus rituximab versus CHOP plus rituximab in the first-line treatment of patients with follicular, indolent and mantle cell lymphomas: results of a randomized phase III study of the Studygroup Indolent Lymphomas (StiL). Presented at the 50th Annual Meeting of the American Society of Hematology, December 6-9 2008, San Francisco, CA. Abstract 2596.

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