A new trial has tested an experimental drug for relapsed or treatment-resistant multiple myeloma.
Belantamab mafodotin, is an antibody-drug conjugate, combining chemotherapy with a targeted antibody which targets the B-cell maturation antigen, or BCMA. It works by delivering chemotherapy directly to myeloma cells, and at the same time recruiting immune cells to attack the cancer.
The treatment was shown to lead to “potentially durable responses” in relapsed or refractory myeloma in this multi-centre, international randomised trial.
Dr Adam Cohen and his team at the Perelman School of Medicine at the University of Pennsylvania, USA, recruited 196 heavily pre-treated patients to the trial. Their disease had either relapsed or was unresponsive to a proteasome inhibitor, immunomodulatory drug, and anti-CD38 antibody. Participants were randomised to receive either a low or high dose of the belantamab mafadotin.
Results were published in the journal Lancet Oncology last week. They show that almost a third of patients achieved a partial response or better when treated with the drug. With a follow up of 6.3 months for the low dose cohort and 6.9 months for the high dose cohort, the median duration of response was not reached in either group. The study continues to collect data for progression-free survival and overall survival for responders
“Our data show this therapy can make a difference for patients with multiple myeloma who have exhausted all other options, including other antibody therapies,” said Dr Cohen.
“These data build off the phase one trial that showed patient responses improved over time and contributed to prolonged progression free survival. Since this study did not reach the median duration of response, we anticipate that further follow-up on these patients will confirm these responses can be durable.
“Overall, the side effects are manageable with appropriate supportive care, and the fact that this treatment can be given once every three weeks as an outpatient infusion means this could be a convenient and beneficial therapy for multiple myeloma patients.”
Lonial S, Lee HC, Badros A, Trudel S, Nooka AK, Chari A, Abdallah A-O, Callander N, Lendvai N, Sborov D, Suvannasankha A, Weisel K, Karlin L, Libby E, Arnulf B, Facon T, Hulin C, Kortüm KM, Rodríguez-Otero P, Usmani SZ, Hari P, Baz R, Quach H, Moreau P, Voorhees PM, Gupta I, Hoos A, Zhi E, Baron J, Piontek T, Lewis E, Jewell RC, Dettman EJ, Popat R, Esposti SD, Opalinska J, Richardson P, Cohen AD (2019) “Belantamab mafodotin for relapsed or refractory multiple myeloma (DREAMM-2): a two-arm, randomised, open-label, phase 2 study”, Lancet Oncology, doi: 10.1016/S1470-2045(19)30788-0