Is Treanda a better mate to Rituxan than CHOP?

Treanda (bendamustine) may soon replace CHOP as the chemotherapy buddy to Rituxan (rituximab) for patients with advanced follicular, indolent, and mantle cell lymphoma who are getting first-line treatment, following research presented today at the American Society of Hematology's annual meeting.A phase 3 German study, dubbed StiL (Study Group Indolent Lymphomas), compared the effectiveness and safety of Rituxan plus Treanda to Rituxan plus CHOP, a cocktail that includes cyclophosphamide, doxorubicin, vincristine, and prednisone. The Treanda study arm included 260 patients; the R-CHOP arm had 253 patients.Rituxan plus Treanda outperformed the traditional R-CHOP regimen at almost every turn. Median progression-free survival (the amount of time the cancer did not progress) hit 54.9 months in the Treanda arm, compared with 34.8 months in the R-CHOP group, and 39.6 percent of patients receiving the Treanda combo had a complete remission (disappearance of all signs of cancer) versus 30 percent of those on R-CHOP. Plus, the R-CHOP arm resulted in a higher frequency of severe side effects, namely neutropenia (46.5 percent versus 10.7 percent) and leukocytopenia (38.2 percent versus 12.1 percent). There were also higher rates of hair loss, nerve damage, and inflammation in the mucous lining of the mouth in the R-CHOP group, although more patients on Treanda developed skin-related side effects.Investigators said that because indolent lymphoma is such a long-term disease, extended follow-up is needed to determine overall survival. They also noted that although these results suggest Treanda is a better partner to Rituxan than CHOP in patients with indolent lymphomas, R-CHOP is still the standard of care for aggressive lymphomas.Treanda has been used for decades in other countries, but it only just gained FDA approval last year for chronic lymphocytic leukemia and indolent (slow-growing) B-cell non-Hodgkin lymphoma. For more on lymphoma, check out "Trying Something New" from the Spring 2009 issue of CURE. And look for more breaking news from ASH in the Winter issue, which drops later this month.