Introduction

Bendamustine is in a class of medications called alkylating agents. It kills existing cancer cells and limits the growth of new cancer cells.

Mechanism of action

Bendamustine Hydrochloride is the hydrochloride salt of bendamustine, a bifunctional mechlorethamine derivative with alkylator and antimetabolite activities. Bendamustine possesses three active moieties: an alkylating group, a benzimidazole ring, which may act as a purine analog, and a butyric acid side chain.

It is a bifunctional mechlorethamine derivative capable of forming electrophilic alkyl groups that covalently bond to other molecules. Through this function as an alkylating agent, bendamustine causes intra- and inter-strand crosslinks between DNA bases, resulting in cell death. It is active against both active and quiescent cells, although the exact mechanism of action is unknown.

Bendamustine may differ from other alkylators in that it may be more potent in activating p53-dependent stress pathways and inducing apoptosis; it may induce mitotic catastrophe; and it may activate a base excision DNA repair pathway rather than an alkyltransferase DNA repair mechanism. Accordingly, this agent may be more efficacious and less susceptible to drug resistance than other alkylators.

Uses

Bendamustine hydrochloride is approved to treat:

B-cell non-Hodgkin lymphoma (NHL) is indolent (slow-growing) and got worse during or within 6 months after treatment with rituximab.

Chronic lymphocytic leukemia (CLL).

Bendamustine hydrochloride is also being studied to treat other types of cancer.

Side effects

Common adverse reactions include nausea, vomiting, diarrhea, fatigue, weakness, skin rashes, itching, some kinds of infection symptoms and body signs (such as persistent sore throat, fever, and chills), easy for bruising/bleeding and ulcers in the mouth; in some severe adverse reactions, there may be bone marrow suppression and tumor lysis syndrome.

It may cause a mild or severe allergic reaction. During the administration process or the early phase of post-administration, there may be some allergic symptoms such as rash, facial swelling, and difficulty in breathing.

It may negatively affect the fetus, so women who are during treatment and within three months after treatment should take appropriate contraceptive measures as well as stop breastfeeding.