Belantamab Combination May Offer an Alternative to CAR-T for Relapsed/Refractory Myeloma

In this article, you’ll learn about treatment combinations for relapsed or refractory multiple myeloma patients and how they compare. A meta-analysis presented at the 2025 European Hematology Association (EHA) conference looked at different treatment combinations to better understand how the combination BVD, which includes belantamab mafodotin (Blenrep, GSK) combined with bortezomib (Velcade, Takeda/Janssen) and dexamethasone compared to the newer CAR T-cell therapy ciltacabtagene autoleucel (Carvykti, Janssen). A meta-analysis combines results from more than one clinical trial to understand how treatments might compare, even if they haven’t been studied in the same clinical trial.

Comparing newer BCMA-targeting therapies 

B-cell maturation antigen (BCMA) is a protein on the surface of myeloma cells. BCMA-targeting treatments work by focusing on this protein while sparing healthy cells. These include belantamab mafodotin (Blenrep, GSK), an antibody-drug conjugate, and ciltacabtagene autoleucel, also known as cilta-cel. Cilta-cel is a form of CAR T-cell therapy that uses a patient’s own modified immune cells.

Both have shown better outcomes compared to older treatment regimens. For example, the CARTITUDE-4 trial showed that patients treated with cilta-cel lived longer without their disease progressing than those who received combinations like daratumumab, pomalidomide, and dexamethasone (DPD) or pomalidomide, bortezomib, and dexamethasone (PVD).

Similarly, in the DREAMM-7 and DREAMM-8 studies, belantamab mafodotin with bortezomib and dexamethasone and belantamab with pomalidomide and dexamethasone also performed better than some standard therapies.

We interviewed Dr. Meletios Dimopoulos, presenter of the DREAMM-8 study data.

Using network meta-analysis to compare therapies

Head-to-head clinical trials directly comparing treatments like belantamab mafodotin and cilta-cel are not available. To help bridge that gap, researchers conducted a network meta-analysis, which is a statistical method that indirectly compares multiple treatments using data from several different clinical trials.

They looked at trials published between January 2016 and December 2024 and focused on measuring progression-free survival (PFS), which is the time a patient lives without the disease getting worse.

Belantamab combination therapy performed similarly to CAR-T

The analysis found that BVD had a similar effect on progression-free survival as ciltacabtagene autoleucel. This means that the BVD combination may be a useful alternative to CAR-T, especially when CAR-T is not accessible or appropriate. It can help patients live longer without their myeloma progressing.

BVD outperformed other regimens

Beyond cilta-cel, BVD showed better outcomes than several other treatment combinations, including those involving CD38-targeting antibodies like isatuximab and daratumumab. Specifically, BVD outperformed combinations such as isatuximab with carfilzomib and dexamethasone and daratumumab with carfilzomib and dexamethasone.

It also showed stronger performance than the belantamab with pomalidomide and dexamethasone combination (BPD). People treated with BVD had a 60% lower risk of cancer progression than people treated with BPD.

These comparisons may help patients and their care teams choose therapies that are more likely to delay disease progression, especially after multiple relapses.

What’s next for BVD?

BVD offers a similar benefit to CAR T-cell therapy in keeping myeloma from progressing. It also showed stronger results than many other combinations. This analysis helps patients understand that more than one effective BCMA-targeting therapy exists and that treatment decisions can be based on many factors. beyond disease biology, such as availability, side effect profiles, and support systems.

Belantamab was recently approved for use in Japan. And in the United Kingdom, it was recently recommended for approval by the European Medicines Agency. In the United States, it received accelerated approval in 2020, but the approval was rescinded in 2022 when results of the DREAMM-3 clinical trial did not meet expected endpoints. Now, with results from the DREAMM-7 and DREAMM-8 clinical trials showing an improvement in progression-free survival, the U.S. Food and Drug Administration (FDA) has accepted a Biologics License Application for belantamab. A decision is expected from the FDA in July. 

Talking with your care team about how each treatment option fits into your health goals, lifestyle, and prior therapies to make informed decisions. If you don’t have a myeloma specialist in your care team you can use HealthTree’s Specialist Directory to find one near you. 

Sources: 

• RESULTS FROM THE RANDOMIZED PHASE 3 DREAMM-8 STUDY OF BELANTAMAB MAFODOTIN PLUS POMALIDOMIDE AND DEXAMETHASONE VSPOMALIDOMIDE PLUS BORTEZOMIB AND DEXAMETHASONE IN REPALPSED/REFRACTORY MULTIPLE MYELOMA 
• BELANTAMAB MAFODOTIN PLUS BORTEZOMIB/DEXAMETHASONE SHOWS SIMILAR PROGRESSION-FREE SURVIVAL TO CILTACABTAGENE AUTOLEUCEL IN PATIENTS WITH RELAPSED /REFRACTORY MULTIPLE MYELOMA: A NETWORK META-ANALYSIS