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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Monday, February 19, 2024
Patients with relapsed or refractory multiple myeloma appeared to derive a progression-free survival benefit from treatment with the B-cell maturation antigen (BCMA)-targeted antibody-drug conjugate belantamab mafodotin-blmf plus bortezomib and dexamethasone (BVd) vs standard-of-care daratumumab, bortezomib, and dexamethasone (DVd), according to Maria-Victoria Mateos, MD, PhD, of Hospital Universitario de Salamanca, Spain, and colleagues. The results of the phase III DREAMM-7 trial, which were presented during the February 2024 American Society of Clinical Oncology (ASCO) Plenary Series (Abstract 439572), highlight the potential for BVd to become a new standard of care in this setting.
Briefly, in August 2020, the U.S. Food and Drug Administration granted accelerated approval to belantamab mafodotin for patients who had received at least four prior therapies (including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent). However, disappointing progression-free survival findings from the DREAMM-3 confirmatory trial led to its withdrawal from the market.
In the present study, patients who underwent at least one prior line of therapy were randomly assigned to receive either BVd (n = 243) or DVd (n = 251). At a median follow-up of 28.2 months, the duration of progression-free survival was prolonged with BVd vs DVd (median, 36.6 vs 13.4 months; hazard ratio [HR] = 0.41; P < .00001). Overall survival data were 29% mature; the median duration was not reached in either arm (HR = 0.57; nominal P < .0005). The overall response rate was 82.7% with BVd and 71.3% with DVd. The median durations of response were 35.6 and 17.8 months, respectively.
All patients experienced at least one adverse event. Treatment-related adverse events of grade 3 or 4 were reported in 90% of patients treated with BVd and 67% of those who received DVd. The investigators observed serious adverse events in 50% and 37% of patients, respectively. Ocular adverse events were documented more frequently with BVd vs DVd (79% vs 29%) and were reported to be manageable.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
