COMy 2023 | Antibody-drug conjugates in multiple myeloma: current status and future considerations
Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD, University College London Hospitals, London, UK, discusses the promise of antibody-drug conjugates (ADCs) in the treatment of multiple myeloma. Dr Popat explains that although several ADCs have been investigated, there are challenges with bringing these agents into clinical practice due to their toxicity concerns. Following this, Dr Popat shares some updates on the use of belantamab mafodotin and clinical trials investigating this agent. This interview took place at the 9th World Congress on Controversies in Multiple Myeloma (COMy) 2023, held in Paris, France.
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Transcript (edited for clarity)
Antibody-drug conjugates represent a new class of therapy for multiple myeloma. If you look at the history of antibody-drug conjugates in myeloma, it’s quite checkered in that a number of agents have been investigated but unfortunately have not moved until registration. And this is really due to the toxicity associated with the payload and trying to balance the efficacy and the toxicity, which can be quite challenging with antibody-drug conjugates...
Antibody-drug conjugates represent a new class of therapy for multiple myeloma. If you look at the history of antibody-drug conjugates in myeloma, it’s quite checkered in that a number of agents have been investigated but unfortunately have not moved until registration. And this is really due to the toxicity associated with the payload and trying to balance the efficacy and the toxicity, which can be quite challenging with antibody-drug conjugates. But I think if you look across cancer and other hematological malignancies, there are clear examples of benefits of ADCs. And so I think there is work to do to try and incorporate these into routine practice. The one that has been licensed is belantamab mafodotin and of course this is now being used routinely in Europe, although unfortunately has been withdrawn from the US market. The DREAMM-2 results have been published and the latest final analysis continues to demonstrate a significant benefit for patients that are triple-class refractory. And importantly, the overall survival is now at 15 months. And for those patients who are in VGPR and greater, there is a 30-month overall survival. Now the DREAMM-3 data will be presented at ASCO, but we’ve already heard the frontline data which demonstrates that there was an improvement in progression-free survival, but this was not statistically significant and hence this study did not meet its primary endpoint and I’m looking forward to hearing that data. But the future will be in combinations and the data with pomalidomide and belantamab is looking very interesting with a median progression-free survival of 21 months for triple-class exposed patients. And so the Phase III study will be reporting this year and that will be very interesting to look out for.
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