Safety and efficacy of belantamab mafodotin with pembrolizumab in patients with relapsed or refractory multiple myeloma

Background: Belantamab mafodotin (belamaf) has shown promising antimyeloma activity in relapsed or refractory multiple myeloma (RRMM) as a single agent. It was hypothesized that its multimodal activity may be enhanced by programmed cell death protein 1 pathway inhibition and activation of T cell-med...

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Autores: Suvannasankha, Attaya|||0000-0001-9445-8781, Bahlis, Nizar J.|||0000-0001-7353-7034, Trudel, Suzanne, Weisel, Katja, Koenecke, Christian, Oriol, Albert|||0000-0001-6804-2221, Voorhees, Peter M., Alonso, Aranzazu A., Callander, Natalie S., Mateos, M. V.|||0000-0003-2390-1218, Reddy, Nishitha, Hakim, Shawn, LaMacchia, John, Patel, Nashita, Williams, Danaé, Jewell, Roxanne C., Zhou, Xiangdomg, Gupta, Ira, Opalinska, Joanna, Nooka, Ajay K.|||0000-0003-4165-6869
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:311538
Acceso en línea:https://ddd.uab.cat/record/311538
https://dx.doi.org/urn:doi:10.1002/cncr.35319
Access Level:acceso abierto
Palabra clave:Belantamab mafodotin
Pembrolizumab
Refractory multiple myeloma
Dose-escalation
Dose-expansion
Benefit-risk profile
Safety
Descripción
Sumario:Background: Belantamab mafodotin (belamaf) has shown promising antimyeloma activity in relapsed or refractory multiple myeloma (RRMM) as a single agent. It was hypothesized that its multimodal activity may be enhanced by programmed cell death protein 1 pathway inhibition and activation of T cell-mediated antitumor responses. This study investigated the efficacy and safety of belamaf with pembrolizumab in patients with RRMM. Methods: DREAMM-4 (NCT03848845) was an open-label, single-arm, phase 1/2 study divided into dose-escalation (part 1) and dose-expansion (part 2) phases. Patients were ≥18 years old with ≥3 prior lines of therapy including a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 agent. Patients received belamaf (2.5 or 3.4 mg/kg, part 1; 2.5 mg/kg, part 2) and 200 mg pembrolizumab for ≤35 cycles. Results: Of 41 enrolled patients, 34 (n = 6 part 1, n = 28 part 2) who received 2.5 mg/kg belamaf plus pembrolizumab were included in this final analysis. Sixteen patients (47%) achieved an overall response. Minimal residual disease negativity was achieved in three of 10 patients who had very good partial response or better. Five of eight patients who had prior anti-B-cell maturation antigen therapy achieved partial response or better, including two who had B-cell maturation antigen-refractory disease. Common grade ≥3 adverse events were keratopathy (38%) and thrombocytopenia (29%). Despite belamaf-related ocular events, quality-of-life measures remained stable over time. No new safety signals were observed. Conclusions: The results of DREAMM-4 demonstrated clinical activity and a favorable safety profile of belamaf plus pembrolizumab in patients with RRMM.