Also known as: Treanda
Canadian Status: Bendamustine is not yet approved in Canada for the treatment of follicular lymphoma. However, it is currently being used in several Canadian clinical trials, including a comparison of rituximab + bendamustine with R-CHOP/R-CVP.
Drug Information: Bendamustine is an important alkylating agent, in the same class of drug as the more commonly used cyclophosphamide. It was first developed in East Germany during the Cold War, and afterwards was "re-discovered" by Western drug researchers. It appears to be much more effective against numerous types of cancer, including follicular lymphoma, compared to other existing drugs in the same class.
Side effects can be serious, and include vomiting (40%), fatigue (65%), diarrhea (40%) or constipation (30%), fever (35%), loss of appetite, headaches, weight loss, skin rash, reduced immune system strength leading to infection (70%), and stomatitis (mouth inflammation and sores).
Effectiveness and Trial Information: Bendamustine has been extensively researched both in monotherapy and combination therapy in clinical trials. It may eventually replace CHOP/CVP in combination with rituximab as a standard first-line treatment for follicular lymphoma.
As a single agent, bendamustine causes responses in up to 75% of pretreated patients. One trial showed an overall response rate of 75%, with 17% entering complete remission. However, it also showed that 6% of people died, possibly as a result of treatment.