Evaluating second-line rituximab-bendamustine treatment for patients with follicular lymphoma

This study evaluated the safety and effectiveness of the BR (bendamustine, rituximab) regimen as a second-line treatment for patients with follicular lymphoma (FL) who had disease progression (tumor growth or spread) after chemoimmunotherapy. The study concluded that this regimen was effective in these patients.

Bendamustine (Treanda) is a chemotherapy drug. This type of treatment damages the DNA inside cancer cells, leading to cancer cell death. Rituximab (Rituxan) is a monoclonal antibody. This type of treatment helps the body’s immune system attack cancer cells, leading to cancer cell death.

For patients with FL, the bendamustine–rituximab (BR) regimen has been widely used for front-line treatment. However, whether this regimen is also effective as a second-line treatment for patients who experience disease progression after initial treatment remains unclear.

This study involved 31 patients with FL. All patients were previously treated with rituximab plus chemotherapy. In this study, all patients received BR as a second-line treatment. 20 patients (64.5%) then received maintenance therapy with rituximab to delay relapse (cancer recurrence). Patients were followed-up for an average of 68 months.

Overall, 48.4% of patients had complete disappearance of all signs of cancer (complete response). 25.8% of patients had tumor shrinkage (partial response). 

The average progression-free survival (time from treatment until disease progression; PFS) was 33 months. Five-year PFS (patients still alive 5 years later without disease progression) was 42%. Five-year overall survival (patients still alive 5 years later) was 74%.

During BR treatment, 80% of patients reported severe side effects. The most common side effects included low white blood cell count (45%), extreme fatigue or weakness (6%), and anemia (3%).

This study concluded that the BR regimen was effective in patients with FL who had disease progression after first-line chemoimmunotherapy.

The patient population in this study was small. Larger studies are needed to confirm the role of the BR regimen in the second-line treatment of patients with FL.