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How to sequence BCMA-directed therapies in early relapsed/ refractory multiple myeloma
At the ESH 7th Translational Research Conference:
Multiple Myeloma
with Martin Kaiser, Mohamad Mohty, and Rakesh Popat
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BVd vs DVd in patients with R/R MM: Results from the DREAMM-7 trial
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Belantamab mafodotin, a BCMA-targeted antibody-drug conjugate, has demonstrated efficacy in patients with multiple myeloma (MM). The phase III DREAMM-7 trial (NCT04246047) is assessing the safety and efficacy of belantamab mafodotin in combination with bortezomib and dexamethasone (BVd) vs daratumumab plus bortezomib and dexamethasone (DVd) in patients with relapsed/refractory (R/R) MM with ≥1 prior line of therapy.1 Results from this trial were presented by Mateos1 during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting. |
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The DREAMM-7 study met its primary endpoint of progression-free survival (PFS): median PFS was 36.6 months vs 13.4 months in the BVd and DVd arms, respectively (p < 0.00001); this benefit was sustained across prespecified subgroups, including patients with lenalidomide-refractory or high-risk cytogenetic MM. |
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BVd also improved overall survival (OS) vs DVd, with 12-month and 18-month OS rates of 87% vs 81% and 84% vs 73%, respectively. |
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BVd was associated with a higher ≥complete response (CR) rate (34.6% vs 17.1%) and a higher ≥CR with measurable residual disease-negativity rate (24.7% vs 9.6%) when compared with DVd. |
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The safety profile of BVd was consistent with that of the individual agents, and ocular adverse events were generally manageable, leading to discontinuation in 9% of patients. |
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These results suggest that BVd could be a new standard of care for patients with R/R MM. |
- Mateos MV. Results from the randomized phase III DREAMM-7 study of belantamab mafodotin (belamaf) + bortezomib, and dexamethasone (BVd) vs daratumumab, bortezomib, and dexamethasone (DVd) in relapsed/refractory multiple myeloma (RRMM). Abstract #439572. American Society of Clinical Oncology Annual Meeting; May 30 – Jun 3, 2024; Chicago, US.
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