EBMT 2022 | An update on the use of belantamab mafodotin in multiple myeloma

When we think about belamaf, which is a BCMA-directed antibody-drug conjugate, what we’re beginning to see are combination studies. We did see updates on data combining belamaf with pomalidomide in the Algonquin study from the Canadian Myeloma Group, suggesting that not only do you get additive benefit when you put these drugs together, you likely get some level of synergy, given that IMiDs do enhance the efficacy of antibodies. And while belamaf is an antibody-drug conjugate, it does actually kill myeloma cells through ADCC as well, so immune-enhancing mechanisms do partner well with it.
We also saw data at ASH this year, where belamaf was looked at in the frontline setting, both with lenalidomide and dexamethasone or other combinations. And what we’re looking at is, obviously, better response rates and depth of response when combining a BCMA antibody-drug conjugate, but more importantly, we’re also seeing that perhaps the dose and schedule of belamaf can be changed. There were studies looking at split dosing of belamaf and studies looking at every 4-week dosing, every 6-week dosing. And I think what we’re beginning to understand is that you can get good combinatorial effect by combining belamaf with commonly used induction regimens, but the dosing, perhaps, can be less frequent to reduce the incidence of corneal adverse events. This is really important, because in the newly diagnosed myeloma setting, the tolerance for grade 3 or grade 4 corneal events is certainly lower for most patients, given that they do have other options, and I think these new regimens and schedules are giving us opportunities to take full advantage of that.