Effectiveness of Bendamustine-Rituximab Compared to R-CHOP/R-CVP as a First-Line Treatment of Indolent Non-Hodgkin’s Lymphoma or Mantle-Cell Lymphoma

Authors

  • Brenda Cristie Edina Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Ikhwan Rinaldi Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Keywords:

internal medicine, medical journal, hematology oncology, medical oncology

Abstract

Background: R-CHOP/R-CVP is the only recommended first-line treatment for Non-Hodgkin’s Lymphoma (NHL). Limited treatment alternatives often lead to relapse and refractory NHL, which increases disease progressivity and worsens prognosis. Bendamustine-rituximab is being studied for its potential as a superior first-line therapy for indolent NHL and mantle-cell NHL (MCL); however, it is not in the national guidelines. Evidence-based research is needed to demonstrate the effectivity of bendamustine-rituximab compared to R-CHOP/R-CVP for a complete response of indolent NHL and MCL. Methods: A literature search was conducted using PubMed, Scopus, EBSCOHost, and Cochrane. Studies consistent with clinical question and eligibility criteria were included and critically appraised using the Oxford Centre for Evidence-Based Medicine (CEBM) tool. Results: Two randomized controlled trials (RCTs) were included in this study, both concluding that bendamustine-rituximab is superior to R-CHOP/R-CVP with a complete response, with RR values of 0.90 (95% CI 0.80 – 1.01) and 0.86 (95% CI 0.76 – 0.98). Conclusion: Bendamustine-rituximab is more effective than R-CHOP/R-CVP as a first-line treatment of indolent NHL or MCL.

Author Biographies

Brenda Cristie Edina, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

Student of the Faculty of Medicine University of Indonesia

Ikhwan Rinaldi, Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Medical Hematology Oncology Division, Departement of Internal Medicine, Faculty of Medicine University of Indonesia

References

GLOBOCAN 2018. Worldwide Cancer Incidence. Geneva: IARC WHO; 2019.

GLOBOCAN 2018. Indonesia Cancer Incidence. Geneva: IARC WHO; 2019.

Chiu BCH, Weisenburger DD. An update of the epidemiology of non-hodgkin’s lymphoma. Clin Lymphoma. 2003;4(3):161-8.

Komite Nasional Penanggulangan Kanker. Panduan Penatalaksanaan Limfoma Non-Hodgkin. Jakarta: Kementerian Kesehatan Republik Indonesia; 2015.

Coiffier B, Sarkozy C. Diffuse large B-cell lymphoma R-CHOP failure-what to do? Hematology Am Soc Hematol Educ Program. 2016;2016(1):366-78.

Dreyling M, Ghielmini M, Rule S, Salles G, Vitolo U, Ladetto M. Newly diagnosed and relapsed follicular lymphoma: ESMO clinical practice guidelines. Ann Oncol. 2016; 27(suppl5): v83-v90.

Dreyling M, Campo E, Hermine O, et al. Newly diagnosed and relapsed mantle cell lymphoma: ESMO clinical practice guidelines. Ann Oncol. 2017; 28(suppl 4): iv62-iv71.

Flinn IW, Jagt R, Kahl BS, et al. First-line treatment of patients with indolent non-hodgkin lymphoma or mantle-cell lymphoma with bendamustine plus rituximab versus R-CHOP or R-CVP: Results of the BRIGHT 5-year follow-up study. J Clin Oncol. 2019; 37(12):984-91.

Flinn IW, Jagt R, Kahl BS, et al. Randomized trial of Bendamustine-Rituximab or R-CHOP/R-CVP in first-line treatment of indolent NHL or MCL: The BRIGHT study. Blood. 2014;123(19):2944-52.

Rummel J, Nierdele N, Maschmeyer G, Banat GA, Grunhagen U, Losem C, et al.

Anna LK. Obat kanker limfoma diproduksi di dalam negeri, harga lebih terjangkau [Internet]. Jakarta: KOMPAS; 2018 [cited 2020 Mar 31]. Available from: https://sains.kompas.com/read/2018/01/29/090000923/obat-kanker-limfoma-diproduksi-di-dalam-negeri-harga-lebih-terjangkau.

Keputusan Menteri Kesehatan Republik Indonesia nomor HK. 01.07/MENKES/707/2018. Tentang Perubahan Atas Keputusan Menteri Kesehatan nomor HK.01.07/MENKES/659/2017. Tentang Formularium Nasional. Menteri Kesehatan Repulik Indonesia; 2018.

Ota I, Shinohara K, Muraki K, et al. Two cases of non-Hodgkin’s lymphoma in first degree relatives. Japanese Journal of Clinical Oncology. 2000;30(12):571-3.

GLOBOCAN 2018. Non-Hodgkin Lymphoma. Geneva: IARC WHO; 2019.

Mondello P, Steiner N, Willenbacher W, et al. Bendamustine plus Rituximab versus R-CHOP as first-line treatment for patients with follicular lymphoma grade 3A: Evidence from a multicenter, retrospective study. Oncologist. 23(4):454-60.

Downloads

Published

2022-07-07

How to Cite

Edina, B. C., & Rinaldi, I. (2022). Effectiveness of Bendamustine-Rituximab Compared to R-CHOP/R-CVP as a First-Line Treatment of Indolent Non-Hodgkin’s Lymphoma or Mantle-Cell Lymphoma. Acta Medica Indonesiana, 54(2), 316. Retrieved from https://actamedindones.org/index.php/ijim/article/view/1584

Issue

Vol. 54 No. 2 (2022): Acta Medica Indonesiana

Section

SPECIAL ARTICLE

License

Copyright

The authors who publish in this journal agree to the following requirements:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a  Creative Commons Attribution 4.0 International License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)

Privacy Statement

The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.