Gemcitabine and bendamustine is a safe and effective salvage regimen for patients with recurrent/refractory Hodgkin lymphoma: Results of a phase 1/2 study

Jonathon B Cohen, Lai Wei, Kami J Maddocks, Beth Christian, Leonard T Heffner, Amelia A Langston, Mary Jo Lechowicz, Pierluigi Porcu, Christopher R Flowers, Steven M Devine, Kristie A Blum, Jonathon B Cohen, Lai Wei, Kami J Maddocks, Beth Christian, Leonard T Heffner, Amelia A Langston, Mary Jo Lechowicz, Pierluigi Porcu, Christopher R Flowers, Steven M Devine, Kristie A Blum

Abstract

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/m2 on day 1) and bendamustine (120 mg/m2 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.

Keywords: Hodgkin lymphoma; bendamustine; chemotherapy; clinical trial; gemcitabine.

© 2019 American Cancer Society.

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