Dr Mateos on Belantamab Mafodotin Plus Bortezomib/Dexamethasone in R/R Myeloma

María-Victoria Mateos, MD, PhD, hematologist/oncologist, associate professor of medicine, director, Myeloma Program and Clinical Trials Unit, University of Salamanca, discusses findings from subgroup analyses of the phase 3 DREAMM-7 trial (NCT04246047) evaluating belantamab mafodotin (Blenrep) combined with bortezomib (Velcade) and dexamethasone (BVd) vs daratumumab (Darzalex) plus bortezomib and dexamethasone (DVd) in patients with relapsed/refractory multiple myeloma.

Findings presented at the 2024 ASCO Annual Meeting showed that in the intention-to-treat (ITT) population, BVd (n = 243) led to a median progression-free survival (PFS) of 36.6 months (95% CI, 28.4–not reached [NR]) compared with 13.4 months (95% CI, 11.1-17.5) for DVd (n = 251; HR, 0.41; 95% CI, 0.31-0.53; P < .00001).

The subgroup analyses showed that the PFS benefit observed with BVd was seen across prespecified subgroups, Mateos notes, including in patients who were refractory to lenalidomide (Revlimid; HR, 0.31; 95% CI, 0.19-0.48) and those who were not refractory to lenolidomide (HR, 0.48; 95% CI, 0.34-0.68). For patients with disease that was refractory to lenalidomide, the median PFS was 25.0 months (95% CI, 18.1-NR) for BVd (n = 79) compared with 8.6 months (95% CI, 6.4-13.5) for DVd (n = 87; HR, 0.31; 95% CI, 0.19-0.48).

In the high-risk cytogenetic subgroup, BVd (n = 67) elicited a median PFS of 33.2 months (95% CI, 20.3-NR) vs 10.5 months (95% CI, 7.6-13.4) for DVd (n = 69; HR, 0.31; 95% CI, 0.18-0.52).

Notably, safety findings for the BVd regimen were consistent within these prespecified subgroups compared with the data from the ITT population.

Within the multiple myeloma patient population, those with high-risk cytogenetics or lenalidomide-refractory disease have historically been more difficult to treat, Mateos says. She concludes by noting that the PFS benefits and durable responses observed with BVd are promising within these subgroups, and this regimen could represent a new option for patients following first disease relapse.