Dr Neparidze on Belantamab Mafodotin Plus Elotuzumab in R/R Myeloma

Natalia Neparidze, MD, associate professor, internal medicine (hematology), research leader, Myeloma Program, Yale University School of Medicine, discusses findings from the phase 1b/2 Bela-Elo trial (NCT05002816) evaluating the safety, tolerability, and preliminary efficacy of the combination of belantamab mafodotin-blmf (Blenrep) and elotuzumab (Empliciti) in heavily pretreated patients with relapsed/refractory multiple myeloma.

The trial enrolled patients with triple-class refractory multiple myeloma, including those with progression following prior BCMA-targeted therapies. Notably, 8 of the 10 patients enrolled thus far were also penta-drug refractory, Neparidze explains. The median age of enrolled patients was 66.5 years (range, 59-79), and patients received a median of 5 prior lines of therapy (range, 2-8). Notably, 3 patients had extramedullary disease.

Findings presented at the 2024 ASCO Annual Meeting showed that no dose-limiting toxicities were observed in the 10 evaluable patients treated during the study. Any-grade adverse effects included neutropenia (n = 2), anemia (n = 1), thrombocytopenia (n =2), lymphopenia (n = 3), pulmonary infections (n = 3), nausea/vomiting (n = 2), and ocular keratopathy (n = 4). Notably, all instances of ocular keratopathy were grade 1 or 2 and resolved with discontinuation or dose reduction of belantamab mafodotin.

Efficacy data showed that a partial response (PR) was observed in 40% of patients, and stable was reported in another 30%. Notably, 2 of the 4 patients who received prior BCMA-directed therapies achieved a PR, including 1 patient who had a duration of response of 19 months, Neparidze says. In the patients who experienced stable disease, the outcomes appeared durable, which could be clinically meaningful for a heavily pretreated patient population, Neparidze adds.

Further directions for this research included correlative studies to evaluate genomic and immune profiles to identify potential predictive biomarkers of response for this combination. The efficacy and safety data derived from Bela-Elo thus far have been encouraging, Neparidze concludes.