Dr Biran on Current Unmet Needs in Relapsed/Refractory Multiple Myeloma

Noa Biran, MD, associate professor, medicine, Hackensack Meridian School of Medicine, physician, Division of Multiple Myeloma, John Theurer Cancer Center, Hackensack Meridian Health, discusses the investigation of belantamab mafodotin-blmf (Blenrep) plus bortezomib (Velcade) and dexamethasone (BVd) in the phase 3 DREAMM-7 trial (NCT04246047) for patients with relapsed or refractory multiple myeloma.

Multiple myeloma is a chronic illness, though in recent years, new treatments for this disease have been approved, Biran begins. Although these advancements have improved the outlook for patients with multiple myeloma, the disease typically relapses, and most patients eventually succumb to it, she explains. Previously, a primary research concern was finding ways to treat patients who were triple refractory, meaning those who were resistant to the most common treatments: proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies, Biran reports. Now, the focus has shifted to patients who have progressed after receiving BCMA-directed therapy, according to Biran. These BCMA-exposed or refractory patients currently have a critical unmet need in multiple myeloma, necessitating the rapid development of new therapies, she says.

The DREAMM-7 trial addressed this need by comparing 2 treatment regimens in patients with early relapsed myeloma, Biran continues. The trial evaluated the standard-of-care regimen of daratumumab (Darzalex), bortezomib, and dexamethasone (DVd) against a new combination, BVd. This head-to-head comparison of triplet regimens revealed a significant improvement in duration of response with the new combination, she reports. Furthermore, the median progression-free survival was greater for patients treated with the belantamab mafodotin combination compared with DVd.

These findings are particularly important because belantamab mafodotin had previously been approved by the FDA but was later withdrawn from the United States market due to concerns about its efficacy and toxicity, Biran continues. The results of the DREAMM-7 trial may prompt the FDA to reconsider its stance on the agent, potentially leading to the approval of BVd for use in the early relapsed setting, she elucidates. This could provide a crucial new treatment option for patients who have few alternatives after their disease progresses following BCMA-directed therapy, Biran concludes.