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ASCO 2025 | Belantamab treatment for R/R myeloma: results from part I of the DREAMM-20 trial
Belantamab is a naked BCMA monoclonal antibody (mAb) without the conjugated monomethyl auristatin-F (MMAF) payload utilized in the antibody-drug conjugate belantamab mafodotin. The safety and efficacy of belantamab in patients with relapsed/refractory (R/R) multiple myeloma (MM) is being explored in the Phase I/II DREAMM-20 trial (NCT05714839). In this interview, Hang Quach, MBBS(Hons), SpecCertOC, FRACP, FRCPA, MD, St. Vincent’s Hospital & University of Melbourne, Melbourne, Australia, presents the results from part I of this study, highlighting the favorable safety prolife and encouraging efficacy observed in a heavily pretreated cohort of patients. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
At this ASCO meeting I had the privilege of presenting the initial data of part one of the DREAMM-20 study. The DREAMM-20 study is a Phase I/II study evaluating belantamab in patients with relapsed/refractory multiple myeloma. Belantamab is a naked monoclonal antibody targeting BCMA that works mainly via antibody-dependent cytotoxicity and phagocytosis of myeloma cells without the MMAF component of belantamab mafadotin...
At this ASCO meeting I had the privilege of presenting the initial data of part one of the DREAMM-20 study. The DREAMM-20 study is a Phase I/II study evaluating belantamab in patients with relapsed/refractory multiple myeloma. Belantamab is a naked monoclonal antibody targeting BCMA that works mainly via antibody-dependent cytotoxicity and phagocytosis of myeloma cells without the MMAF component of belantamab mafadotin.
At this ASCO, we presented 18 patients who were enrolled in a part one dose escalation, six each in each of the cohort of 300 milligrams, 900 milligrams and 2,000 milligrams of belantamab given intravenously every two weeks until disease progression. These patients were heavily pre-treated patients, median age 76, notably 17 out of the 18 patients were triple class-exposed and two patients had prior BCMA targeted therapy.
With respect to safety, there were no DLTs noted. The main toxicities were hematological toxicities and infusion-related reactions. Infusion-related reactions only occurred in four patients but these were mainly mild and were effectively managed with simple observation or paracetamol. Grade 3 neutropenia occurred in 22% of patients, noting that these are heavily pre-treated patients.
With respect to efficacy, five out of 18 patients responded, with an overall response rate of 28% and a VGPR of 17%. Importantly, these responses were quite durable, in that four out of the five patients responded for over a year and at the time of data cutoff, three out of five patients continued on treatment.
So overall, the preliminary data of part one of the DREAMM-20 study demonstrate that belantamab is quite tolerable with no DLTs and with a promising efficacy in heavily pretreated patients with multiple myeloma.
Looking forward, part two of the DREAMM-20 study is underway exploring belantamab in an alternating regimen with spaced-out belantamab mafadotin designed to optimize efficacy and minimize toxicity. And overall I think that this combination has the potential to be one of the most tolerable off-the-shelf anti-BCMA targeted therapies for patients with relapsed/refractory multiple myeloma.
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