ASH 2024 | A real-world retrospective analysis of belantamab mafodotin in R/R multiple myeloma

Belantamab mafodotin is an antibody drug conjugate that was previously approved and available as monotherapy for commercial use in the US. This was based on the results of the DREAMM-1 and DREAMM-2 studies, but confirmatory trials failed to establish the superiority and benefit of this treatment in comparison to standard of care chemotherapy. So it has been taken off of the US market. But there have been more recently some clinical trials that have evaluated combinations of belantamab with other therapies and have established both a benefit in regards to the efficacy as well as safety. In this particular multicenter retrospective analysis, we pulled in data for five different centers and looked at patients who received belantamab mafodotin under a commercial label at the time it was available commercially for use in the US. We had about a total of 80 patients, a majority of whom were actually either triple-class exposed, had triple-class refractory and penta-refractory disease. Nearly one third of these patients had EMD, high-risk cytogenetics, and had poor performance status. They received belantamab mafodotin as monotherapy. And amongst these patients, with 81 patients, we had a median follow-up of around 12 months. And we noticed that these patients have a response rate of about 40%, 15% complete response rates. and with a median follow-up of nearly 12 months. Median progression-free survival was around 5 months, and overall survival was around 12 months. Some of the patient and disease characteristics that predicted inferior outcomes were the presence of extramedullary disease, presence of high-risk cytogenetics, poor performance status, and triple-class refractory status in these particular patients. We also noticed that these patients experienced keratopathy in nearly 70% of the patients, with grade 3 keratopathy occurring in about 50% of the patients requiring treatment discontinuation and treatment delays and holds as well. In summary, what we learned from this particular multicenter retrospective analysis is that in a real-world practice, when many of the patients, because of their disease status, comorbidities, frailty, and prior exposures, may not have been eligible for clinical trials, received belantamab mafodotin as monotherapy, and still kept the same benefits in regards to safety and efficacy in a real-world population.

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