IMS 2025 | Optimizing the dose of belamaf in transplant-ineligible NDMM: insights from the DREAMM-9 trial

DREAMM-9 study is a newly diagnosed transplant ineligible myeloma patient study exploring the combination of belantamab mafodotin with bortezomib, lenalidomide and dexamethasone. So we’re looking at a quadruplet combination which is now in clinical practice but with a CD38 monoclonal antibody and we have used belantamab mafodotin, which is a BCMA targeting antibody drug conjugate. This was a dose and schedule optimization study. We’ve looked at doses ranging from 1.9 milligram per kilogram to 1.4 milligram per kilogram. We’ve also looked at frequency being given every three to four weeks all the way up to six to eight weeks. We have recruited over 100 patients, about 12 patients in each cohort, that is being studied over eight cohorts. The principal messages that I’m coming out with at the IMS meeting is after about a three-year follow-up in this study, we are finding very high MRD negativity rates in patients exposed to 1.9 milligram per kilogram, and we’re finding those patients in stretch cohorts, as we call it, given belantamab mafodotin in the six to eight weekly frequency are the patients with the lowest amount of grade 3-4 adverse events, and this is a schedule that’s been taken forward in the DREAMM-10 study, which is a triplet combination of belantamab mafodotin with lenalidomide and dexamethasone, and patients are being recruited around the world into this study, and we really hope that we can get high activity and efficacy for patients with transplant ineligible newly diagnosed myeloma.

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