Pharmacokinetic evaluation and therapeutic activity of bendamustine in B-cell lymphoid malignancies

Abstract

Introduction: Bendamustine, a cytotoxic agent comprising structural features of both an alkylating drug and a purine nucleoside analog, was approved by the US FDA for treatment of chronic lymphocytic leukemia (CLL) and indolent B-cell non-Hodgkin's lymphoma (NHL). Additionally, in Europe the drug has been also approved for treatment of multiple myeloma (MM) and in Asia, especially in Japan for refractory/relapsed NHL and mantle cell lymphoma.

Areas covered: The authors present the chemical structure, mechanism of action, pharmacokinetic properties and clinical application of bendamustine in hematological malignancies. Publications in English related to the above, up to June 2012, have been surveyed in the MEDLINE database. Conference proceedings reports from the last 5 years are also included. Additional relevant publications have been obtained by reviewing the references from the chosen articles.

Expert opinion: The availability of bendamustine provides an effective treatment option for patients with lymphoid malignancies. Several recent clinical trials have documented the activity of bendamustine in CLL, NHL and MM, both as a single agent and in combination with other cytotoxic drugs. However, doses, schedules and also the role of bendamustine in treatment of patients with hematological malignancies should be further investigated to establish its real place in the management of these diseases.

Keywords::

• bendamustine
• clinical efficacy
• lymphoid malignancies
• mechanism of action
• metabolites
• pharmacokinetic properties