ASH 2025 | Long-term responders from the Phase III DREAMM-7 study of Bela-Vd versus Dara-Vd in R/R myeloma

DREAMM-7 is a Phase III trial comparing belantamab, pomalidomide, bortezomib, and dexamethasone versus daratumumab, bortezomib, and dexamethasone in patients with relapse or refractory multiple myeloma after at least one prior line of therapy. In this post-hoc analysis, long-term responders were defined as patients who had progression-free survival of 36 months or longer. All patients remaining on study have been on study for over 36 months. And overall, the Bela-Vd arm had a higher proportion of longer-term responders than the DVd arm at 32% versus 19%. Among long-term responders, deeper responses led to long-term efficacy, benefits in patients treated with Bela-Vd versus Dara-Vd. A complete response, or better, was observed in 72% of patients treated with Bela-Vd who achieved a long-term response. Among those treated with Dara-Vd, CR, or better was observed in 57% of patients. A similar trend was observed in MRD negativity. In Bela-Vd-treated long-term responders who achieved a CR or better, 75% were MRD negative versus 70% in Dara-Vd. Likewise, 73% of Bela-Vd-treated long-term responders who achieved the VGPR or better were MRD-negative versus 58% in the Dara-Vd. Lower rates of disease response and MRD-negativity were observed in patients who did not achieve long-term responses. However, even among these patients, a higher proportion achieved the deeper responses and the MRD negativity with Bela-Vd than with Dara-Vd. Patients with long-term responses treated with Bela-Vd demonstrated an extended duration of response versus those treated with Dara-Vd. Median duration of response was not reached in the Bela-Vd arm versus 47.7 months in the Dara-Vd arm. Deep and durable responses translated to PFS benefit with Bela-Vd in long-term responders. The median PFS was not reached in the Bela-Vd arm versus 48.5 months in the Dara-Vd arm. The safety profile of Bela-Vd in patients with long-term response was consistent with the previously reported results. No fatal series of adverse events associated with any component of the treatment regimen were observed. In summary, Bela-Vd-treated long-term responders had deeper and more durable responses and prolonged the PFS versus those treated with daratumumab.

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