Bendamustine

General information

Class/mechanism: Nitrogen mustard, alkylator; bifunctional mechlorethamine derivative containing a purine-like benzimidazole ring which forms electrophilic alkyl groups, resulting in interstrand DNA crosslinks, leading to cell death via several pathways in both quiescent and dividing cells.
Route: IV
Extravasation: vesicant

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Chronic lymphocytic leukemia (CLL) and Small lymphocytic lymphoma (SLL)
• Cutaneous T-cell lymphoma
• Diffuse large B-cell lymphoma
• Follicular lymphoma
• Hairy cell leukemia
• Hodgkin lymphoma
• Mantle cell lymphoma
• Marginal zone lymphoma
• Multiple myeloma
• Peripheral T-cell lymphoma
• Transformed lymphoma
• Transplant conditioning regimens
• Waldenström macroglobulinemia

Patient drug information

• Bendamustine (Treanda) patient drug information (Chemocare)
• Brief patient counseling information can be found in the Bendamustine (Bendeka) package insert
• Brief patient counseling information can be found on page 7 of the package insert
• Bendamustine (Bendeka) patient drug information (UpToDate)

History of changes in FDA indication

As Bendamustine (Treanda):

• 3/20/2008: Initial FDA approval "for the treatment of patients with chronic lymphocytic leukemia (CLL)."
• 4/22/2009: Additional indication for "Indolent B-cell non-Hodgkin’s lymphoma (NHL) that has progressed during or within six months of treatment with rituximab or a rituximab­ containing regimen."

As Bendamustine (Bendeka):

• 12/7/2015: Bendamustine (Bendeka) formulation FDA approved for "Chronic lymphocytic leukemia (CLL). Efficacy relative to first line therapies other than chlorambucil has not been established. Indolent B-cell non-Hodgkin lymphoma (NHL) that has progressed during or within six months of treatment with rituximab or a rituximab-containing regimen."

Also known as

Bendamustine Hydrochloride, Ribomustin, SDX-105, or Treakisym. Previous Treanda formulation discontinued on 3/31/2016 by Teva to switch to Bendeka.