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ICML 2025 | The safety of bendamustine-rituximab and acalabrutinib in frontline Waldenström’s macroglobulinemia
Neil Berinstein, MD, Sunnybrook Odette Cancer Centre, Toronto, Canada, discusses the safety of bendamustine-rituximab and acalabrutinib in frontline Waldenström’s macroglobulinemia. He states that the toxicities from both treatments are non-overlapping and do not increase the risk of grade three or four neutropenia, hypertension, atrial fibrillation, or bleeding. This interview took place during the 18th International Conference on Malignant Lymphoma (18-ICML) in Lugano, Switzerland.
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Transcript
Initially we were worried about the possibility of there being added side effects by adding two different treatment combinations, one bendamustine rituximab, which is a standard treatment on its own, and acalabrutinib, which is another independent treatment, and when you put those two treatments together you might anticipate that there would be some additional toxicities, but it turns out in our clinical trial that because the toxicities from both of those types of treatments are not overlapping, we didn’t see any side effects that were beyond what we would have expected for either treatment alone...
Initially we were worried about the possibility of there being added side effects by adding two different treatment combinations, one bendamustine rituximab, which is a standard treatment on its own, and acalabrutinib, which is another independent treatment, and when you put those two treatments together you might anticipate that there would be some additional toxicities, but it turns out in our clinical trial that because the toxicities from both of those types of treatments are not overlapping, we didn’t see any side effects that were beyond what we would have expected for either treatment alone. The grade 3, grade 4 neutropenia treatment-related adverse event in the trial that we performed was about 30%, which is actually lower than was seen with bendamustine rituximab alone. Adding acalabrutinib did not increase grade 3, grade 4 neutropenia. Because we’re only using a very short duration of the BTK inhibitor acalabrutinib, we don’t see any of the toxicities of special interest of BTK inhibitors. These are toxicities like increasing hypertension, atrial fibrillation, bleeding. We didn’t see any of those events in our trial. So it turned out that the toxicity profile was very acceptable. Nothing extraordinary, nothing different than we would have anticipated.
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