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BR is a standard-of-care chemoimmunotherapy regimen comprising bendamustine, a bifunctional alkylating agent, and rituximab, a chimeric monoclonal antibody targeting the CD20 antigen. This combination is widely utilized in the treatment of various indolent B-cell non-Hodgkin lymphomas, including follicular lymphoma (FL) and mantle cell lymphoma (MCL), as well as chronic lymphocytic leukemia (CLL). Bendamustine exerts its cytotoxic effect by forming intra-strand and inter-strand DNA cross-links, which interfere with DNA replication and transcription, leading to cell cycle arrest and apoptosis. Rituximab binds to CD20 on the surface of B-lymphocytes, mediating cell lysis through complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC), and the induction of direct apoptosis. In clinical trials such as SOUNDTRACK-F1, BR serves as a benchmark comparator for evaluating the efficacy of novel therapies, such as surovatamig (AZD0486), in previously untreated follicular lymphoma.
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