Clinical Medicine Reviews in Oncology

Bendamustine is a unique bifunctional cytotoxic agent that includes a nitrogen mustard group with alkylating properties and a benzimidazole ring with potential antimetabolite properties. It shows only partial cross-resistance with other alkylators in vitro and remains highly active in heavily pretreated patients. The history of bendamustine began in the former East German Democratic Republic, where it was developed in the early 1960s. Re-discovered in the 1990s, it demonstrated excellent response rates in several clinical trials with a favorable side-effect profile leading to its approval in 2008 by the U.S. Food and Drug Administration for the treatment of patients with chronic lymphocytic leukemia and for the treatment of patients with rituximab-refractory, indolent B-cell non-Hodgkin lymphoma. Further studies showed efficacy in the first-line treatment of B-cell NHL and in the treatment of patients with multiple myeloma. We review the data on bendamustine published so far and discuss the future role of this promising agent in the treatment of patients with lymphoproliferative malignancies.