Belantamab mafodotin in RRMM: Latest updates and practical considerations

The Multiple Myeloma Hub spoke with Christoph Renner, University of Basel, Basel, CH. We asked about the use of belantamab mafodotin-based combination therapy for relapsed/refractory multiple myeloma (RRMM). 

During this interview, Renner provides an overview of pivotal clinical data from the DREAMM-7 (NCT04246047) and DREAMM-8 (NCT04484623) trials that supported regulatory approvals of belantamab mafodotin-based combinations in RRMM and outlines practical considerations for their use in clinical practice. Renner discusses patient selection and treatment sequencing alongside other BCMA-directed therapies, as well as the monitoring and management of associated ocular toxicities. Renner draws on his experience in Switzerland and highlights the importance of multidisciplinary collaboration, particularly between hematology and ophthalmology, to support the management of ocular toxicities and inform treatment decisions.

Key points 

• Belantamab mafodotin is a B-cell maturation antigen (BCMA)-directed antibody–drug conjugate carrying the microtubule inhibitor monomethyl auristatin F (MMAF), which is internalized following binding to BCMA and induces myeloma cell death through microtubule disruption and apoptosis.^1,2 
• The phase III DREAMM-7 and DREAMM-8 trials demonstrated improved progression-free survival and response outcomes with belantamab mafodotin-based combinations compared with their respective control regimens, alongside higher rates of measurable residual disease (MRD) negativity and sustained MRD negativity.^3,4 
• Results from DREAMM-7 and DREAMM-8, which supported regulatory approvals of belantamab mafodotin-based combinations in RRMM, have previously been reported on the Multiple Myeloma Hub. 
• Belantamab mafodotin-based combinations have received regulatory approval for RRMM across multiple jurisdictions.  
• The European Commission and Swissmedic approved belantamab mafodotin plus bortezomib and dexamethasone (BVd) after ≥1 prior therapy, and belantamab mafodotin plus pomalidomide and dexamethasone (BPd) after ≥1 prior therapy, including lenalidomide.^5,6  
• The FDA approved BVd after ≥2 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent.⁷ 
• The optimal sequencing of belantamab mafodotin with other BCMA-directed therapies remains to be established, with the potential impact of prior BCMA-directed treatment on subsequent therapies requiring consideration.¹ 
• Patient selection and treatment sequencing should be individualized, taking into account eligibility for other BCMA-directed therapies and available treatment options.⁸ 
• Belantamab mafodotin is associated with off-tumor/off-target ocular toxicity, including keratopathy that can affect visual function.^1–4  
• Ophthalmologic assessment before treatment administration can support the detection and grading of ocular toxicity and inform decisions regarding dose interruption, dose reduction, or treatment discontinuation according to severity.² 
• Coordination between the treating team and ophthalmology services is important for the monitoring and management of ocular toxicity, including in outpatient settings.² 
• As chimeric antigen receptor (CAR) T-cell therapies and bispecific antibodies move into earlier lines of treatment, the role and sequencing of belantamab mafodotin-based combinations should be considered within the evolving BCMA-directed treatment landscape.  

Updated data from the DREAMM-7 and DREAMM-8 trials were presented at the European Hematology Association (EHA) 2026 Congress, June 11–14, 2026, Stockholm, SE. The Multiple Myeloma Hub spoke with experts about the 4-year results from DREAMM-7 and subgroup analyses from DREAMM-8, including findings in patients with early RRMM and analyses of sustained MRD negativity. Explore the interviews below to learn more. 

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