ASCO: Drug combination shows significant superiority in relapsed or refractory multiple myeloma

Researchers report that adding belantamab mafodotin to pomalidomide and dexamethasone for the treatment of relapsed or refractory multiple myeloma is more effective at slowing disease progression or death than standard-of-care bortezomib plus pomalidomide and dexamethasone.

The research was presented on June 2, 2024 at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.

“The DREAMM-8 trial demonstrates that the first-in-class BCMA-targeted antibody-drug conjugate—belantamab mafodotin—plus pomalidomide and dexamethasone (BPd) is significantly more effective than the PVd regimen (pomalidomide, bortezomib, and dexamethasone), cutting the risk of disease progression or death by nearly half in patients with relapsed or refractory multiple myeloma. The findings of this trial suggest that BPd is poised to be a potential new treatment strategy for relapsed or refractory multiple myeloma,” said Oreofe O. Odejide, MD, MPH, Assistant Professor of Medicine, Dana-Farber Cancer Institute in Boston.

Investigators enrolled subjects with relapsed and refractory multiple myeloma whose disease had progressed after at least one previous treatment, including lenalidomide. They were randomized to receive belantamab mafodotin plus pomalidomide and dexamethasone (BPd, n=155) or pomalidomide plus bortezomib and dexamethasone (PVd, n=147).

Sixty percent all the subjects were men, 86% were White, and the average age was around 67 years.

On the primary endpoint of progression-free survival (PFS), the authors reported a statistically significant and clinically meaningful improvement (p-value<0.001) with the belantamab mafodotin combination compared to the bortezomib combination.

At a median follow-up of 21.8 months, the median PFS was not yet reached with the belantamab mafodotin combination compared to 12.7 months for the bortezomib combination.

At the end of one year, 71% of subjects in the belantamab mafodotin combination group compared to 51% in the bortezomib combination group were living, and their disease had not progressed.

“This regimen could become an important treatment option for patients with multiple myeloma at first relapse and for subsequent relapses. It is suitable for a broad range of patients and can be given in a community oncology setting without the need for specialized cancer center support,’ said lead study author Suzanne Trudel, MSc, MD, Associate Professor at the Princess Margaret Cancer Centre in Toronto, Ontario.