A New Option for Multiple Myeloma: Belantamab Mafodotin

Data from two recent trials, DREAMM-7 and DREAMM-8, demonstrate the potential of using belantamab mafodotin (brand name: Blendrep) to treat relapsed multiple myeloma.

“To understand the potential of belantamab mafodotin, I think we have to start by understanding what it is,” Dr. Paul Richardson, a medical oncologist at Dana-Farber Cancer Institute who was involved in collecting data for the DREAMM-8 trial, tells SurvivorNet Connect. “It’s a first in class antibody drug conjugate, which leverages BCMA-targeting, which is obviously a key pillar of myeloma therapy now.”

An antibody drug conjugate, Dr. Richardson explains, “leverages BCMA-targeting and delivers a cytotoxic warhead to the tumor cell, so it’s highly selective.” It directly kills the tumor cell but also has an immunogenic effect on the tumor cell. “That attracts the body’s immune system to that tumor cell and optimizes the elimination of that tumor cell.”

Antibody drug conjugates also do not come with the side effects that are sometimes observed with other innovative treatments, like CAR T-cell therapy, Dr. Richardson explains.

“Some of the challenges that we see with powerful bispecifics such as cytokine release syndrome (CRS), and some of the infectious problems that come alongside with the broad targeting of BCMA do not seem to occur with belantamab mafodotin,” he explains. “Similarly, powerful and effective as CAR T can be, some of the more challenging side effects associated with CAR T, including central nervous system toxicity and others, is not something we see with the antibody drug conjugate class.”

With that said, serious side effects are possible — and ocular toxicities are a serious concern with belantamab-combination treatments. However, Dr. Richardson says that data incidacte these side effects can be managed with dose and/or schedule adjustments.