Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, CA.
Ridley-Tree Cancer Center, Santa Barbara, CA.
Clin Lymphoma Myeloma Leuk. 2020 Jul;20(7):453-458. doi: 10.1016/j.clml.2020.02.006. Epub 2020 Feb 20.
Everolimus and bendamustine both have single-agent activity against lymphoid hematologic malignancies. We examined this combination in a group of heavily pretreated patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and multiple myeloma (MM).
In this phase I trial, 18 patients (8 with NHL, 6 with MM, and 4 with HL) were treated with bendamustine 90 mg/m on days 1 and 2 and everolimus from 5 to 10 mg daily on a 28-day cycle, for up to 4 cycles.
Adverse events were generally mild and mostly hematologic in nature. The most frequent grade 3/4 adverse events were lymphopenia (61%), thrombocytopenia (22%), leukopenia (22%), neutropenia (17%), and fatigue (17%). Overall response rate varied by malignancy: diffuse large B-cell lymphoma, 20% (1 of 5 patients); HL (2 of 4 patients), 50%; MM, 80% (4 of 5 patients); and indolent lymphomas, 100% (3 of 3 patients). The maximum tolerated dose of everolimus was determined to be 7.5 mg daily.
The combination of everolimus and bendamustine appeared to be well-tolerated and relatively efficacious.
依维莫司和苯达莫司汀均对淋巴血液恶性肿瘤具有单药活性。我们在一组曾接受过多线治疗的非霍奇金淋巴瘤（NHL）、霍奇金淋巴瘤（HL）和多发性骨髓瘤（MM）患者中研究了该联合用药方案。
在这项 I 期试验中，18 名患者（8 名 NHL、6 名 MM 和 4 名 HL）接受苯达莫司汀 90 mg/m2 治疗，于第 1 和第 2 天给药，依维莫司每天 5 至 10 mg，28 天为一个周期，最多进行 4 个周期。
不良事件通常较轻，主要为血液学毒性。最常见的 3/4 级不良事件是淋巴细胞减少症（61%）、血小板减少症（22%）、白细胞减少症（22%）、中性粒细胞减少症（17%）和疲劳（17%）。根据恶性肿瘤的不同，总缓解率也有所不同：弥漫性大 B 细胞淋巴瘤为 20%（5 例患者中 1 例）；HL 为 50%（4 例患者中 2 例）；MM 为 80%（5 例患者中 4 例）；惰性淋巴瘤为 100%（3 例患者中 3 例）。依维莫司的最大耐受剂量确定为每天 7.5 mg。
依维莫司和苯达莫司汀联合用药方案耐受性良好，疗效相对较好。
