Managing AEs With Belantamab Mafodotin in Relapsed/Refractory Myeloma

Nina Shah, MD: Katja, belantamab mafodotin [Blenrep] has an interesting adverse effect that Sagar mentioned: keratopathy. There’s a program in place to help to monitor and mitigate that. What are some of the recommended strategies to prevent or manage the potential ocular effects of belantamab?

Katja Weisel, MD: First, it’s important to know that any ocular effect is a rare class effect and it’s reversible. This is the most important message we have. We started seeing those adverse effects in the pivotal trials, and we didn’t know what would happen to this toxicity. Now that we’ve had more time learning how to deal with belantamab mafodotin, we can say it’s reversible. The other very good thing we’ve learned is that you can pulse belantamab without losing response in many patients. There’s even a trend to go to a 6-week application regimen, as Josh mentioned. We know that patients should use an eye drop regimen, which reminds us a bit of the high-dose cytarabine regimens in leukemia treatment with combination eye drops. Patients should also avoid wearing contact lenses. For most of the patients, that has a preventive effect for keratopathy.

Outside clinical trials, where we have a strict ophthalmology visit schedule, before you introduce the drug, you should always send a patient to an ophthalmologist to get an overview. We have a lot of older patients with myeloma, and we know that there are other reasons for having ocular impairment. It’s important to get a fundamental base at the start of treatment. In clinical reality, it’s good that the patient is seen repeatedly in the first 3 full cycles. But then it’s enough for the ophthalmologist to see the patient when there are clinical symptoms and there’s a clear clinical impairment.

Nina Shah, MD: Yes. And we know that the drug requires regular contact with an eye care professional in order to fulfill the REMS [Risk Evaluation and Mitigation Strategy] requirement. That’s so we have a way to make sure we’re keeping track of the patient with someone who’s a specialist in ophthalmology or optometry, which is good for us as well.

Transcript Edited for Clarity