Belantamab + Standard of Care for Newly Diagnosed Myeloma (DreaMM-9) | Saad Usmani, MD | #ASH24

Hello. My name is Saad Usmani. I am the chief of the myeloma service at Memorial Sloan Kettering Cancer Center. And I'm here at Ash in San Diego. I presented the belantamab mafodotin with standard of care treatment phase one results at Ash this year.

Essentially this was, a combination of belantamab mafodotin which is a BCmA directed antibody drug conjugate with Vrd, which is, an established standard of care treatment for both transplant eligible as well as ineligible patients.

And the main objective of the study was looking at the safety of this combination, but trying different doses and different schedules. The doses we were exploring were lower than the original, FDA approvals for bela-maf for the relapse setting. So it was 1.9mg/kg dose, 1.4mg/kg dose and the 1mg/kg dose. And the schedule was also different. We had Q three week dosing schedules, Q six week dosing schedules, Q eight and 12 or Q nine and 12 week schedules.

And besides the induction, when patients went into maintenance, the schedule was even further reduced to Q six, Q eight, and even Q 12 weeks. So the key idea was to see the trajectory of responses along with safety. One of the, things that has been noticed with belantamab mafodotin is that because of the drug, or the toxic payload that is delivered to the cells, one of the side effects is, keratopathy and visual activity changes.

And in the higher doses, it can be as high as 75, 80%. What we found with less frequent dosing, you can reduce the high grade symptoms. And then they tend to happen with a delay. But then they also resolve very quickly. So you can interrupt doses and patients can get the efficacy benefit while you manage that side effect.

We know that that side effect is not going away, just like CRS is not going away with, you know, the bispecifics or cars. But we have to find ways in which we can mitigate it. 100% response rates MRD negativity rates of like 67 to 75%. And in some of those, you have a cohorts with 1.9 and 1.4 mg/kg.

So, so it's early, early days, early work. But I think it it sets up the stage for us to explore this combination, in larger studies.