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COMy 2022 | The promise of antibody-drug conjugates for the treatment of multiple myeloma

In this video, Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France, discusses the efficacy of antibody-drug conjugates (ADCs) for the treatment of multiple myeloma. Prof. Mohty first mentions that ADCs have been approved in other hematological indications, including acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and Hodgkin lymphoma (HL). Following this, Prof. Mohty discusses the efficacy of ADCs and the promising results observed with the use of belantamab mafodotin for patients who are refractory to other lines of therapy. To conclude, Prof. Mohty explains the need to further investigate the best way to combine ADCs, and manage side effects such as keratopathy. This interview took place at the 8th World Congress on Controversies in Multiple Myeloma (COMy) 2022, held in Paris, France.

Transcript (edited for clarity)

Antibody-drug conjugates are really a newcomer in the field of myeloma, although we know very well that they are rather well established in the field of cancer and hematology in general. And we have antibody-drug conjugates approved in AML, acute myeloid leukemia, in ALL, acute lymphoblastic leukemia, but also in Hodgkin lymphoma. And the good news, we had a couple of years ago, the approval of the first antibody-drug conjugate in relapsed/refractory multiple myeloma, and this is namely belantamab, which is an antibody-drug conjugate directed against BCMA, a B-cell maturation antigen...

Antibody-drug conjugates are really a newcomer in the field of myeloma, although we know very well that they are rather well established in the field of cancer and hematology in general. And we have antibody-drug conjugates approved in AML, acute myeloid leukemia, in ALL, acute lymphoblastic leukemia, but also in Hodgkin lymphoma. And the good news, we had a couple of years ago, the approval of the first antibody-drug conjugate in relapsed/refractory multiple myeloma, and this is namely belantamab, which is an antibody-drug conjugate directed against BCMA, a B-cell maturation antigen. And this technology of antibody-drug conjugates is really exciting and fascinating and highly effective because actually you are combining the antibody feature, which is like the targeted therapy. But also, thanks to the linker, you are allowing for a robust cytotoxicity. And indeed, it works very well. And belantamab, for instance, is leading to some very interesting results in terms of response rate but in those patients who actually relapsed and were refractory to IMiDs, to proteasome inhibitors, to other available agents. And obviously, as you may guess, the next step is about combinations and how to combine these antibody-drug conjugates and also how to move them earlier in the lines of treatments. Of course, as expected, and this is related usually to the linker in an antibody-drug conjugate, you have to deal with some side effects. And for instance, keratopathy is an issue when it comes to belantamab. However, I think there is a learning curve here and also there are now studies suggesting that by slightly reducing the dosage but also maybe allowing for more time between cycles, one is able actually to reduce the incidents but also the severity of keratopathy. So in summary, I think antibody-drug conjugates will represent in the future a sort of a new major key family for the management of multiple myeloma.

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