Bendamustine

Bendamustine is a bifunctional alkylating agent with cytotoxic activity aga inst human ovarian and breast cancers in vitro. It shows only partial in vi tro cross-resistance with cyclophosphamide, melphalan. carmustine and cispl atin. Bendamustine as monotherapy or as part of combination chemotherapy protocol s for first-line or subsequent treatment produced objective response rates of 61 to 97% in patients with Hodgkin's disease or non-Hodgkin's lymphoma ( NHL) [41 to 48% in high grade NHL]. In patients with multiple myeloma, a bendamustine/prednisone regimen produc ed a higher rate of complete response (32 vs 11%) and more durable response s than a melphalan/prednisone regimen. Substitution of bendamustine for cyclophosphamide in a standard first-line COP regimen (cyclophosphamide, vincristine and prednisolone) yielded simila r response rates in patients with advanced low grade NHL. Substituting bendamustine for cyclophosphamide in the CMF protocol (cycloph osphamide, methotrexate and fluorouracil) prolonged remission from 6.2 to 1 5.2 months in patients with metastatic breast cancer. The most common adverse events in patients receiving bendamustine are haema tological events and gastrointestinal disturbances. Bendamustine has a rela tively low propensity to induce alopecia.