Updates on belantamab mafodotin (BLENREP) were presented at the recent ASH 2021 meeting, showing that it could be successfully combined with other standard of care myeloma drugs. BLENREP is a medication that is a BCMA-targeted antibody-drug conjugate and is the first BCMA-directed therapy that was approved for patients who are:
BLENREP was FDA approved in August of 2020 as a single agent drug. Additional studies like the DREAMM-9 and DREAMM-5 studies are now testing its use in other combinations.
The DREAMM-9 trial is an ongoing phase 1 study which is comparing the use of Blenrep + Velcade, Revlimid, and dexamethasone (which is considered a standard of care) versus Velcade, Revlimid, and dexamethasone as induction therapy in patients with newly diagnosed myeloma who are not eligible for transplant.
Some of the specifics about the DREAMM trial include the following:
One of the biggest concerns with BLENREP is eye problems for a condition called "keratopathy." BLENREP can cause changes to the surface of your eye which can lead to dry eyes, blurred or worsening vision, severe vision loss, and corneal ulcers. In the first study when BLENREP was used alone (and a higher dose level of 2.6), keratopathy was found in over 70% of patients, but not all patients had high grade side effects. With the goal to reduce the side effects for all patients, clinical trials are now testing BLENREP in different combinations to be used with different dosages and schedules. According to ASH presenter Dr. Saad Usmani:
“The safety profile looks good. Corneal events do occur but they don’t lead to discontinuation of treatment. But they do lead to some dose delays.”
The most common side effects of BLENREP include vision or eye problems, nausea, low blood cell counts, fever, infusion-related reactions, tiredness, and changes in kidney or liver function blood tests.
Combining BLENREP with the standard RVd therapy showed the following:
All in all, the preliminary results of the DREAMM trial did not reveal any new safety concerns, and the addition of BLENREP to Velcade, Revlimid, and dexamethasone demonstrated high response rates.
Dr. Saad Usmani shared more on the BLENREP-9 study with HealthTree at the recent ASH meeting.
Dr. Natalie Callander joined HealthTree to explain a sub-group of the DREAMM-5 study. The goal of the DREAMM-5 study is to pair BLENREP individually with 4 other drugs (Feladilimab, Nirogacestatm Dostarlimab or Isatuximab) all in simultaneous groups to see which drug worked best with it in combination.
Dr. Callander shared that when BLENREP was combined with feladilimab, a drug that can stimulate T cells, the combination showed a 52% overall response rate and a lowered percentage of patients (44%) who experienced keratopathy.
In this case, the drug was used without the steroid dexamethasone, which is a bonus for patients.
We look forward to learning more about how this drug could be used in additional combinations to increase outcomes and lower side effects for myeloma patients.
about the author
Patricia is an International Medical Graduate who joined HealthTree in 2020 as part of the Patient Experience team. She helps patients understand and track their lab & genetic test results as well as relevant information from their health history. She loves ballet, traveling, and reading a good science fiction book as often as possible.