Antibody-drug conjugate shows good results in multiple myeloma

According to a new study presented at the 2024 ASCO Annual Meeting, adding the antibody-drug conjugate belantamab mafodotin to pomalidomide and dexamethasone for the treatment of relapsed or refractory multiple myeloma was more effective at slowing disease progression or death compared to current standard of care bortezomib plus pomalidomide and dexamethasone.

The recent DREAMM-7 clinical trial showed that a combination of belantamab mafodotin plus bortezomib and dexamethasone slowed the progression of multiple myeloma if the first treatment did not work when compared to daratumumab plus bortezomib and dexamethasone. The DREAMM-8 study combines belantamab mafodotin with pomalidomide and dexamethasone.

In the DREAMM-8 study, people with relapsed and refractory multiple myeloma whose disease had progressed after at least one previous treatment (including lenalidomide) were randomised to receive belantamab mafodotin plus pomalidomide and dexamethasone, or BPd (n=155) or pomalidomide plus bortezomib and dexamethasone, or PVd (n=147). Of all the participants, 60 per cent were men, 86 per cent were white, and the average age was around 67 years.

After a median follow-up of 22 months, the median progression-free survival (PFS) was not reached for the participants who received BPd. For those who received PVd, the PFS was 12.7 months.

At the end of the first year, PFS was 71 per cent for those receiving BPd compared to 51 per cent of those receiving PVd.

The overall response rate was 77 per cent for those receiving BPd compared to 72 per cent for those receiving PVd. Additionally, 40 per cent of patients treated with BPd achieved a complete response or better compared to 16 per cent of patients who were treated with PVd. Among those with disease that responded to treatment, the median duration of response was not yet reached in those who received BPd, and it was 17.5 months in those who received PVd.

“This regimen could become an important treatment option for patients with multiple myeloma at first relapse and for subsequent relapses. It is suitable for a broad range of patients and can be given in a community oncology setting without the need for specialised cancer centre support,” said lead study author Dr Suzanne Trudel, Associate Professor at the Princess Margaret Cancer Centre in Toronto, Ontario, Canada.