|The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Hematology Advisor’s conference coverage.|
For patients with Waldenström macroglobulinemia, overall response rate, major response rate, time to next therapy, and event-free survival were superior with frontline rituximab plus bendamustine (R-Benda) when compared with frontline rituximab with cyclophosphamide (DRC) or bortezomib, dexamethasone, and rituximab (BDR). These findings were presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
Furthermore, patient outcomes were not found to be influenced by MYD88L265P mutation status in any of the 3 treatment arms, and toxicity was similar across all 3 treatments, with the exception of higher rates of treatment discontinuing neuropathy in patients receiving BDR.
Data were assessed from 222 patients with active Waldenström macroglobulinemia who were treated at the Mayo Clinic between January 2000 and December 2018 with DRC (92 patients), R-Benda (83 patients), or BDR (47 patients). Nearly 8% of patients received rituximab maintenance therapy following the induction therapy (DRC, 9 patients; R-Benda, 5 patients; BDR, 3 patients).
Clinically relevant endpoints across the DRC-, R-Benda-, and BDR-treated patients included overall response rate (76%, 95%, 81%, respectively), major response rate (46%, 93%, 63%, respectively), median time to next therapy (4.9 years, not reached, 4.5 years, respectively), and median event-free survival (4.3 years, not reached, 2.1 years, respectively).
Hematologic toxicities included anemia, thrombocytopenia, and neutropenia; nonhematologic toxicities included fatigue, nausea, infections, neuropathy, dizziness, rituximab infusion reactions, and skin rash.
Limitations of the study included the retrospective, nonrandomized design, underreporting of adverse events, and shorter follow-up in the group of patients who received the R-Benda regimen (median, 2.2 years) compared with patients receiving DRC (median, 5.7 years) and BDR (median, 4.7 years).
1. Abeykoon JP, Zanwar S, Ansell SM, et al. Outcomes with rituximab plus bendamustine (R-Benda), dexamethasone, rituximab, cyclophosphamide (DRC), and bortezomib, dexamethasone, rituximab (BDR) as primary therapy in patients with Waldenstrom macroglobulinemia (WM). Poster presentation at: 2019 ASCO Annual Meeting; June 3, 2019; Chicago, IL. Abstract 7509.