EHA2026 | DREAMM-8: Early RRMM and sustained MRD-negativity subgroup analyses

During the European Hematology Association (EHA) 2026 Congress, June 11–14, 2026, Stockholm, SE, the Multiple Myeloma Hub spoke with Meral Beksaç, Istinye University Ankara Liv Hospital, Ankara, TR. We asked about the key findings from two subgroup analyses of the phase III DREAMM-8 trial (NCT04484623) evaluating belantamab mafodotin + pomalidomide + dexamethasone (BPd) vs pomalidomide + bortezomib + dexamethasone (PVd) in patients with relapsed/refractory multiple myeloma (RRMM).  

Key points 

The ongoing open-label, randomized, phase III DREAMM-8 trial is evaluating the efficacy and safety of BPd vs PVd in patients with RRMM who have received ≥1 prior line of therapy (LoT).^1,2  

DREAMM-8 subgroup analysis in patients who received only one prior LoT¹ 

• This analysis included 159 patients from DREAMM-8 who had received a single prior LoT (BPd, n = 82 [median follow-up, 37.9 months]; PVd, n = 77 [median follow-up, 36.4 months]). 
• BPd was associated with a 2-year progression-free survival (PFS) benefit compared with PVd, which was maintained following subsequent antimyeloma therapy (PFS, 65% vs 36%; PFS2, 74% vs 58%). 
• The overall response rate was 78% in the BPd arm and 88% in the PVd arm; however, more than double the proportion of patients treated with BPd achieved complete response or better (≥CR) vs PVd (51% vs 23%). 
• The ≥CR + measurable residual disease (MRD) negativity rates were 39% in the BPd arm vs 7% in the PVd arm. 
• Sustained MRD negativity at 2-years was observed in 22% of patients in the BPd arm vs 5% in the PVd arm. 
• Safety findings in the second-line setting were generally consistent with the overall DREAMM-8 safety population; Grade 3/4 adverse events were reported in 91% (BPd) and 77% (PVd) of patients. 

DREAMM-8 subgroup analysis in patients with sustained MRD negativity² 

• After a median follow-up of 35.8 months, patients in the intention-to-treat population who received BPd (n = 155) were more than four times as likely than those who received PVd (n = 147) to achieve ≥CR and MRD negativity (27.7% vs 6.1%), as well as sustained MRD negativity (15.5% vs 2.7%). 
• Patients with sustained MRD negativity had durable PFS in both arms; PFS events occurred in 1 of 24 patients in the BPd arm and 0 of 4 patients in the PVd arm.  
• In patients without sustained MRD negativity, median PFS was 21.1 months with BPd (95% confidence interval [CI], 15.0–28.4) vs 10.2 months with PVd (95% CI, 8.6–16.0).  
• Sustained MRD negativity was also associated with durable PFS2 in both arms; PFS2 events occurred in 2 of 25 patients in the BPd arm and 0 of 4 patients in the PVd arm.  
• Among patients without sustained MRD negativity, median PFS2 was 20.2 months with BPd (95% CI, 13.9–24.0) vs 9.3 months with PVd (95% CI, 7.4–11.9). 
• Among patients with sustained MRD negativity treated with BPd (n = 24), 75% had received one prior LoT and 21% had high-risk cytogenetics. 
• Patients treated with BPd who achieved sustained MRD negativity had features consistent with earlier-stage, lower-risk disease, including one prior LoT, sensitivity to previous therapy, International Staging System Stage I disease, and the absence of extramedullary disease or other high-risk features. 
• The safety profile in patients with sustained MRD negativity was similar to previous observations in the overall safety population. 

Conclusion^1,2 

These subgroup analyses support BPd as a treatment option for patients with RRMM, including in earlier lines of therapy and for those with high-risk cytogenetics, and highlight sustained MRD negativity as a marker of durable disease control and long-term clinical benefit across treatment lines.^1,2  

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