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Gemcitabine and bendamustine is a safe and effective salvage regimen for patients with recurrent/refractory Hodgkin lymphoma: Results of a phase 1/2 study
Author(s) -
Cohen Jonathon B.,
Wei Lai,
Maddocks Kami J.,
Christian Beth,
Heffner Leonard T.,
Langston Amelia A.,
Lechowicz Mary Jo,
Porcu Pierluigi,
Flowers Christopher R.,
Devine Steven M.,
Blum Kristie A.
Publication year - 2020
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32640
Subject(s) - medicine , bendamustine , gemcitabine , common terminology criteria for adverse events , adverse effect , refractory (planetary science) , regimen , salvage therapy , surgery , lymphoma , pulmonary toxicity , chemotherapy , toxicity , rituximab , physics , astrobiology
Background Both gemcitabine and bendamustine have been evaluated in patients with recurrent/refractory Hodgkin lymphoma but to the authors' knowledge not as a doublet. The authors completed a phase 1/2 trial to identify the optimal dose and frequency of administration and to assess the efficacy of this combination in patients with recurrent/refractory Hodgkin lymphoma. Methods Patients were treated up to a maximum dose of gemcitabine (1000 mg/m 2 on day 1) and bendamustine (120 mg/m 2 on days 1 and 2), which was determined to be the recommended phase 2 dose, administered every 21 days for up to 6 cycles. Patients could discontinue study therapy after 2 cycles to proceed with autologous or allogeneic stem cell transplantation. Results No dose‐limiting toxicities were identified, but 4 patients experienced grade 3 to 5 pulmonary adverse events (toxicity was graded according to Common Terminology Criteria for Adverse Events [version 4]). A total of 26 patients were enrolled having completed a median of 4 prior lines of therapy (range, 1‐7 lines), including 13 patients at the recommended phase 2 dose, in whom the overall response rate was 69% and the complete response rate was 46%. The median progression‐free survival for the phase 2 patients was 11 months (95% CI, 3 months to not reached), and the median overall survival for this group had not been reached at the time of last follow‐up (95% CI, 4 months to not reached). Conclusions This doublet was found to be tolerable and effective, but patients must be monitored closely for pulmonary toxicity. The authors currently are evaluating this doublet in combination with nivolumab.