Literature DB >> 20140617

Bendamustine pharmacokinetic profile and exposure-response relationships in patients with indolent non-Hodgkin's lymphoma.

Joel S Owen1, Murad Melhem, Julie A Passarell, Denise D'Andrea, Mona Darwish, Bradley Kahl.   

Abstract

PURPOSE: The pharmacokinetic profiles of bendamustine and active metabolites were defined in patients with rituximab-refractory, relapsed indolent B-cell non-Hodgkin's lymphoma, and supported understanding of exposure-response relationships for efficacy and safety.
METHODS: Bendamustine was administered as a 60-min 120 mg/m(2) intravenous infusion on days 1 and 2 of six 21-day cycles. Pharmacokinetic models were developed, with covariate assessment. Correlations between bendamustine exposure and responder status or occurrence of neutropenia, thrombocytopenia, fatigue, nausea, and vomiting were examined.
RESULTS: Following a single dose of bendamustine HCl, concentrations declined in a triphasic manner, with rapid distribution, intermediate, and slow terminal phases. The intermediate t (1/2) (40 min) was considered the pharmacologically relevant (beta elimination) t (1/2) since the initial phases accounted for 99% of the AUC. Age, sex, mild/moderate renal, or mild liver impairment did not alter pharmacokinetics. Metabolite concentrations were low relative to parent. No correlation was observed between exposure and safety or efficacy measures because of the limited range of exposures after 120 mg/m(2) administration, except bendamustine C (max) was a significant (P value = 0.013) predictor of the probability of nausea in patients, most of whom were pretreated with antiemetics.
CONCLUSIONS: The BSA-based dosing regimen for bendamustine achieved the targeted exposure and was associated with a high incidence of therapeutic response. Given the short t (1/2) and low concentrations of bendamustine observed by 12 h after dosing, the single-dose profile for bendamustine described by these analyses is expected to be representative of the multiple-dose profile. The occurrence of nausea was significantly related to bendamustine exposure, with the probability of nausea increasing as bendamustine C (max) increases.

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Year:  2010        PMID: 20140617      PMCID: PMC2956859          DOI: 10.1007/s00280-010-1254-8

Source DB:  PubMed          Journal:  Cancer Chemother Pharmacol        ISSN: 0344-5704            Impact factor:   3.333


  17 in total

Review 1.  Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group.

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5.  Bendamustine prolongs progression-free survival in metastatic breast cancer (MBC): a phase III prospective, randomized, multicenter trial of bendamustine hydrochloride, methotrexate and 5-fluorouracil (BMF) versus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) as first-line treatment of MBC.

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Journal:  Anticancer Drugs       Date:  2005-09       Impact factor: 2.248

6.  Efficacy of bendamustine in patients with relapsed or refractory chronic lymphocytic leukemia: results of a phase I/II study of the German CLL Study Group.

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7.  Some suggestions for measuring predictive performance.

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8.  Characterization of two phase I metabolites of bendamustine in human liver microsomes and in cancer patients treated with bendamustine hydrochloride.

Authors:  Jens Teichert; Frank Baumann; Qi Chao; Craig Franklin; Brandy Bailey; Lothar Hennig; Karel Caca; Konrad Schoppmeyer; Ulrich Patzak; Rainer Preiss
Journal:  Cancer Chemother Pharmacol       Date:  2006-09-07       Impact factor: 3.333

9.  Bendamustine hydrochloride activity against doxorubicin-resistant human breast carcinoma cell lines.

Authors:  D Strumberg; A Harstrick; K Doll; B Hoffmann; S Seeber
Journal:  Anticancer Drugs       Date:  1996-06       Impact factor: 2.248

10.  A phase I study of bendamustine hydrochloride administered once every 3 weeks in patients with solid tumors.

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  23 in total

Review 1.  Bendamustine for treatment of chronic lymphocytic leukemia.

Authors:  Julie Elizabeth Chang; Brad Steven Kahl
Journal:  Expert Opin Pharmacother       Date:  2012-06-05       Impact factor: 3.889

Review 2.  Bendamustine: a review of its use in the management of indolent non-Hodgkin's lymphoma and mantle cell lymphoma.

Authors:  Karly P Garnock-Jones
Journal:  Drugs       Date:  2010-09-10       Impact factor: 9.546

3.  A Canadian perspective on the safe administration of bendamustine and the prevention and management of adverse events.

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Journal:  Curr Oncol       Date:  2014-02       Impact factor: 3.677

4.  A case of Waldenstrom Macroglobulinemia in which intermittent one-day administration cycles of bendamustine were effective for alleviation of nausea and maintenance of remission.

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Review 5.  Bendamustine in indolent non-Hodgkin's lymphoma: a practice guide for patient management.

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Journal:  Oncologist       Date:  2013-07-30

Review 6.  Carmustine replacement in intensive chemotherapy preceding reinjection of autologous HSCs in Hodgkin and non-Hodgkin lymphoma: a review.

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Journal:  Bone Marrow Transplant       Date:  2017-01-23       Impact factor: 5.483

7.  Development and validation of sensitive liquid chromatography/tandem mass spectrometry method for quantification of bendamustine in mouse brain tissue.

Authors:  Lei He; John C Grecula; Yonghua Ling; Michael D Enzerra; Mario Ammirati; Kari Kendra; Robert Cavaliere; Nina Mayr; John McGregor; Thomas Olencki; Ewa Mrozek; Mani Matharbootham; Chima Oluigbo; Mitch A Phelps
Journal:  J Chromatogr B Analyt Technol Biomed Life Sci       Date:  2012-08-16       Impact factor: 3.205

8.  Investigation of bendamustine HCL in a phase 2 study in women with resistant ovarian cancer.

Authors:  Amanda F Baker; Denise J Roe; Cynthia Laughren; Janice L Cohen; Heather M Wright; Mary C Clouser; Haiyan Cui; David S Alberts; Setsuko K Chambers
Journal:  Invest New Drugs       Date:  2012-05-13       Impact factor: 3.850

Review 9.  Bendamustine: a review of its use in the management of chronic lymphocytic leukaemia, rituximab-refractory indolent non-Hodgkin's lymphoma and multiple myeloma.

Authors:  Sheridan M Hoy
Journal:  Drugs       Date:  2012-10-01       Impact factor: 9.546

10.  Dose dependent effects on cell cycle checkpoints and DNA repair by bendamustine.

Authors:  Neil Beeharry; Jerome B Rattner; Alfonso Bellacosa; Mitchell R Smith; Timothy J Yen
Journal:  PLoS One       Date:  2012-06-29       Impact factor: 3.240

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