Belantamab in Combination With Dexamethasone Demonstrates Good Clinical Activity in Triple-Class Relapsed/Refractory MM

Outcomes in relapsed/refractory myeloma remain poor, and novel therapy approaches are necessary, according to findings from a study published in Clinical Lymphoma, Myeloma & Leukemia (doi:https://doi.org/10.1016/j.clml.2022.08.003).

Tahani Ateih (DO, University of Kansas Cancer Center, Kansas City, KS) and colleagues noted that triple-class relapsed/refractory multiple myeloma (RRMM) is associated with a poor prognosis. In this study, the researchers investigated the clinical outcomes of belantamab mafadotin in combination with dexamethasone (Bd) in triple-class RRMM.

In the retrospective study, 35 patients with triple-class RRMM who received Bd at the University of Kansas from October 2019 to November 2021 were identified. The average age was 66 years (42-85) and the average number of prior lines of therapy was five.

Nineteen (54%) patients had R-ISS stage III disease, 15 (43%) patients had high-risk cytogenetics, and 15 patients (43%) had extramedullary disease.

Eight patients received prior B cell maturation antigen (BCMA)-targeted therapy. Overall response rate was 43%, with 23% achieving very good partial response and better.

At an average follow up of 10.7 months, the median progression-free survival and overall survival were 4.9 and 10.7 months, respectively.

The most common adverse event (AE) was keratopathy, which occurred in 30 (86%) patients. Twenty-four patients required dose reduction or delay due to keratopathy. Other common toxicities included anemia (83%), thrombocytopenia (80%), neutropenia (34%), and elevated liver function tests (51%).

The authors indicate that this analysis demonstrates that Bd has good activity in triple-class RRMM and keratopathy remains a challenging AE as well as the primary cause of dose decrease, delay, and treatment termination.

“Our results demonstrated the activity of this combination in heavily pretreated relapsed refractory myeloma, including those previously exposed to BCMA-targeted therapy, and supports ongoing research using belantamab mafadotin in combination with other anti-myeloma therapies in this population,” concluded the authors.