Department of Internal Medicine, Wayne State University, Detroit Medical Center, Detroit, MI, USA.
Clin Med Insights Oncol. 2011;5:145-56. doi: 10.4137/CMO.S6085. Epub 2011 May 18.
Bendamustine (Treanda, Ribomustin) was recently approved by the US Food and Drug Administration (FDA) for treatment of patients with rituximab refractory indolent lymphoma and is expected to turn into a frontline therapy option for indolent lymphoma. This compound with amphoteric properties was designed in the former Germany Democratic Republic in 1960s and re-discovered in 1990s with multiple successive well-designed studies. Bendamustine possesses a unique mechanism of action with potential antimetabolite properties, and only partial cross-resistance with other alkylators. Used in combination with rituximab in vitro, bendamustine shows synergistic effects against various leukemia and lymphoma cell lines. In clinical studies, bendamustine plus rituximab is highly effective in patients with relapsed-refractory indolent lymphoma, inducing remissions in 90% or more and a median progression-free survival of 23-24 months. The optimal dosing and schedule of bendamustine administration is largely undecided and varies among studies. Results of ongoing trials and dose-finding studies will help to further help ascertain the optimal place of bendamustine in the management of indolent NHL.
苯达莫司汀（Treanda，Ribomustin）最近获得美国食品和药物管理局（FDA）批准，用于治疗利妥昔单抗难治性惰性淋巴瘤患者，预计将成为惰性淋巴瘤的一线治疗选择。这种具有两性特性的化合物是在 20 世纪 60 年代在前东德设计的，20 世纪 90 年代通过多项精心设计的研究重新发现。苯达莫司汀具有独特的作用机制，具有潜在的抗代谢物特性，与其他烷化剂仅有部分交叉耐药性。体外与利妥昔单抗联合使用时，苯达莫司汀对各种白血病和淋巴瘤细胞系表现出协同作用。在临床研究中，苯达莫司汀加利妥昔单抗对复发/难治性惰性淋巴瘤患者非常有效，诱导缓解率达 90%以上，无进展生存期中位数为 23-24 个月。苯达莫司汀给药的最佳剂量和方案在很大程度上尚未确定，并且在研究之间存在差异。正在进行的试验和剂量发现研究的结果将有助于进一步确定苯达莫司汀在惰性 NHL 治疗中的最佳位置。
