Why has Bendeka replaced Treanda?

• Teva replaced Treanda with Bendeka in 2016.
• This was because Bendeka is compatible with polycarbonate or acrylonitrile-butadiene-styrene (ABS)-containing infusion equipment, and Treanda was not.
• Bendeka also has a shorter infusion time than Treanda.
• Bendeka has the same indications for use and side effects as Treanda.
• Treanda is still available through Cephalon, a subsidiary company of Teva.

In January 2016 Teva announced that it was replacing Treanda (bendamustine HCl) with Bendeka (bendamustine HCl). The reasons for this were:

• Bendeka has a shorter infusion time than Treanda (10 minutes for Bendeka Vs. 30-60 minutes for Treanda)
• Bendeka is also compatible with closed system transfer devices (CSTDs), adaptors, and syringes containing polycarbonate or acrylonitrile-butadiene-styrene (ABS) because it does not contain N, N-dimethylacetamide (DMA), which Treanda does contain
• Bendeka has the same indications for use as Treanda
• Bendeka and Treanda have a similar rate of side effects.

Treanda is still available through Cephalon Inc., a subsidiary company of Teva.

Both Bendeka and Treanda contain bendamustine HCl which may be used to treat chronic lymphocytic leukemia (CLL) or indolent (slow-growing) B-cell non-Hodgkin lymphoma that has progressed despite treatment.

How does bendamustine work?

Bendamustine is a nitrogen mustard derivative that is classified as an alkylating agent.

A cell cycle goes through three phases: resting, active growing, and mitosis (division). Alkylating agents work best in the resting phase of the cell cycle, although they may also work in the active phase. Bendamustine is active against both resting and dividing cells.

Although the exact way bendamustine works is not known, the structure of it means that it readily forms bonds with other electron-rich structures, which result in interstrand DNA crosslinks and very strong (covalent) bonds. This bonding can lead to cell death in several different ways.

Because cancer cells divide more rapidly than normal cells, they are more affected by this bonding and the death rate of cancerous cells is greater than the death rate of normal cells. This slows the growth of cancer cells in the body.

What are the side effects of bendamustine?

Although bendamustine is more effective at killing cancerous cells compared to normal cells, normal cells are still affected, which results in side effects.

Normal cells most affected by chemotherapy with bendamustine are blood cells, and cells in the mouth, stomach, and bowel. The most common side effects of bendamustine include:

• Black tarry stools
• Bleeding gums
• Blood in the urine or stools
• Diarrhea
• Constipation
• Cough
• Difficulty breathing
• Headache
• Loss of appetite
• Low red and white blood cell numbers, low platelets
• Mouth ulcers and irritation
• Nausea
• Rash
• Stuffy or runny nose
• Tiredness
• Weight loss.

Other side effects that may occur include:

• Infections or a recurrence of infections
• Kidney or liver damage
• Other cancers
• Leaking of bendamustine into the surrounding skin causing burning or stinging
• Swelling of the eyelids, face, lips, hands, or feet.