In a nutshell
This study aimed to compare the safety and effectiveness of bendamustine–rituximab (BR) and chlorambucil–rituximab (Chl-R) as a front-line treatment in older patients with chronic lymphocytic leukemia (CLL). This study concluded that both treatments are good options for these patients.
The first-line treatment for patients with CLL commonly includes chemotherapy with fludarabine (Fludara). However, this treatment is poorly tolerated by older patients. Previous studies have investigated treatment combinations for patients with CLL who cannot tolerate fludarabine-based treatment.
One such combination is bendamustine (Treanda) and rituximab (Rituxan) or BR. The other possible combination is chlorambucil (Leukeran) and rituximab or Chl-R. Bendamustine and chlorambucil are chemotherapies. Rituximab is a type of targeted therapy called a monoclonal antibody.
It was unknown if the safety and effectiveness of BR and Chl-R were similar in older patients with CLL.
Methods & findings
This study involved 192 untreated CLL patients aged over 65 years. 111 patients were treated with BR and 81 with Chl-R. Patients were followed up for an average of 72-73 months.
The overall response rates for the BR group was 93.6% compared to 86.5% for the Chl-R group. Significantly more patients in the BR group achieved a complete response (54.9%) compared to the Chl-R group (30.9%). The progression-free survival (PFS), time to retreatment (TTR) and overall survival (OS) rates were not statistically different between the two groups.
The BR group experienced a higher blood and bone marrow-related number of side effects (48%) compared to the Chl-R group (28%). The BR group also reported more non-blood-related side effects such as infections, digestive problems, and skin side effects compared to the Chl-R group.
The non-blood-related side effects were more common in patients aged over 75 who were treated with BR when compared to those of the same age group treated with Chl-R.
The bottom line
This study concluded that both BR and Chl-R treatments are good treatment options for older untreated CLL patients. For patients aged over 75, the Chl-R combination provides similar outcomes with fewer side effects.
The fine print
This study was based on medical records. The patients were not randomly assigned to the treatments. This might have affected the results.
Published By :
Frontiers in oncology
Jun 27, 2020