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COMy 2022 | The promise of belantamab mafodotin for the treatment of multiple myeloma

Paul Richardson, MD, Dana-Farber Cancer Institute, Boston, MA, shares some insights into the progress that has been made in the myeloma treatment landscape throughout the COVID-19 pandemic, drawing focus on belantamab mafodotin. Dr Richardson highlights the benefits of this antibody-drug conjugate (ADC) and its ability to be combined with other agents, including pomalidomide and bortezomib. To conclude, Dr Richardson discusses the management and treatment of keratopathy associated with belantamab mafodotin. This interview took place at the 8th World Congress on Controversies in Multiple Myeloma (COMy) 2022, held in Paris, France.

Transcript (edited for clarity)

I think the important first thing is, it’s so nice to be at COMy, and a first face-to-face meeting since the pandemic. So, for me personally, this is my first overseas trip since then. It’s been absolutely lovely. I just want to thank Mohamed and Arnon and the organizers for a really outstanding meeting, as always.

I would say that this, probably, has been the best meeting because it has that lovely feeling of everyone being back together...

I think the important first thing is, it’s so nice to be at COMy, and a first face-to-face meeting since the pandemic. So, for me personally, this is my first overseas trip since then. It’s been absolutely lovely. I just want to thank Mohamed and Arnon and the organizers for a really outstanding meeting, as always.

I would say that this, probably, has been the best meeting because it has that lovely feeling of everyone being back together. Despite the challenges of the pandemic, we’ve had real progress in the myeloma space during the last two and a half years. I think in that context, the belantamab mafodotin story has been particularly important actually, because targeting BCMA, we know matters. The question is how do you do it? In the year of the pandemic, having an outpatient antibody-targeted therapy that you can literally take off the shelf and deliver to a patient, recognizing the challenges with some of the ocular toxicity, but these are manageable and they’re outpatient. So this is important.

The other thing is that, belantamab mafodotin does not cause a CRS or cytokine release syndrome. It doesn’t require hospitalization. And so there are aspects to it that make it attractive, especially in the era of the pandemic, as a very useful potential approach. So what we sought to do, was really show the latest data with belantamab mafodotin. Especially in combination, I thought, to Dr Trudel’s discussion around the combination with pomalidomide was particularly impressive. In fact, if you look at the PFS, the median PFS in her study, which I think is really quite impressive, her updated data suggests we’re north of almost 20 months for a median PFS in a subgroup of patients, which for a relapsed/refractory population is quite important. Above all, oral therapy once every four-to-six-week infusions.

That’s the other takeaway, is that belantamab being administered either at, not every three weeks, but either every six weeks or even every eight weeks has become a real-world approach to using it. So, lots of excitement around the combinations. In short, the idea that you can combine it with pomalidomide, you can combine it with bortezomib, for example. We’re also studying it in the context of using gamma secretase inhibitors and so forth. There are a variety of new approaches going forward.

One of the most important aspects of the conversation at this meeting was the management of the keratopathy and the ocular toxicity. I think what was very critical, was to understand what the ophthalmologists observe using their obviously sophisticated tools of assessment of corneal injury. And at the same time, what the patient’s reporting. I think reassuringly, the corneal injury is reversible.

Very importantly, there are simple strategies that may mitigate it, including the appropriate use of lubricants in the eye, especially artificial tears to moisturize the eye. I think then also, practicalities around the infusion of belantamab mafodotin, that the use of an infusion over at least an hour. The use of hydration with a drug. The fact that the interval can be spaced out, and you retain efficacy. All of these were incredibly valuable takeaways for practitioners.

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