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IMS 2026 | Phase II ALANIS trial: belantamab mafodotin combinations in newly diagnosed light-chain amyloidosis
Shaji Kumar, MD, Mayo Clinic, Rochester, MN, discusses the Phase II ALANIS study (NCT07224672) evaluating belantamab mafodotin in combination with bortezomib, cyclophosphamide and dexamethasone in newly diagnosed light-chain amyloidosis. He highlights the rationale for replacing daratumumab with the BCMA-targeted antibody-drug conjugate belantamab mafodotin, with the aim of achieving deeper and more durable responses and potentially faster organ responses. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
So the treatment of amyloidosis, light-chain amyloidosis, has changed quite a bit over the past years, particularly after the introduction of daratumumab based on the Andromeda data. Now, that has firmly placed daratumumab, bortezomib, cyclophosphamide, and dexamethasone as the initial therapy for patients with light-chain amyloidosis. Now, we also know that belantamab-mafodotin, which is an antibody drug conjugate targeting BCMA, is very effective against plasma cell malignancies...
So the treatment of amyloidosis, light-chain amyloidosis, has changed quite a bit over the past years, particularly after the introduction of daratumumab based on the Andromeda data. Now, that has firmly placed daratumumab, bortezomib, cyclophosphamide, and dexamethasone as the initial therapy for patients with light-chain amyloidosis. Now, we also know that belantamab-mafodotin, which is an antibody drug conjugate targeting BCMA, is very effective against plasma cell malignancies. We saw the data from the Phase III DREAMM trial that compared belantamab against daratumumab in combination with bortezomib and dexamethasone in relapsed disease and demonstrated improved PFS and overall survival, suggesting that a BCMA-targeted approach may be more effective in targeting the monoclonal plasma cells than an anti-CD38 monoclonal antibody. So we wanted to take those learnings from the myeloma setting to the amyloid setting and see if we can improve upon the daratumumab VCD combination by using belantamab VCD combination and see if we can get deep and durable responses. And that is the basis of the Andromeda-like study, which will compare these two regimens, the “Alanis” was not clear so changed to Andromeda-like for coherence. And we anticipate that we might see deeper responses and a faster response that in turn will allow for a quicker organ response in patients with light-chain amyloidosis.
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