Dr Neparidze on the Implications of Early Data for 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 the clinical implications of data from the phase 1b/2 Bela-Elo trial (NCT05002816), which evaluated 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. She also explains the next steps for this study.

Findings presented at the 2024 ASCO Annual Meeting showed that no dose-limiting toxicities were reported in the 10 evaluable patients treated during the study. Any-grade adverse effects consisted of 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). No grade 3 or higher ocular keratopathy occurred, and all these events resolved following discontinuation or dose reduction of belantamab mafodotin.

Regarding efficacy, the overall response rate was 40%, which was comprised of 4 patients achieving a partial response (PR). Three additional patients experienced stable disease. Notably, 2 of 4 patients who received a prior BCMA-directed therapy had a PR with median durations of response of 19 months and 9 months, respectively.

The safety and tolerability profile of this combination has been favorable thus far, Neparidze explains, adding that this regimen can also be administered in an outpatient setting. Given the early efficacy observed in patients with heavily pretreated relapsed/refractory multiple myeloma, including those who received prior BCMA-targeted therapy, the data suggest that belantamab mafodotin plus elotuzumab may represent a potential therapeutic option for patients who have exhausted other treatment options, she continues.

Regarding future directions, Neparidze explains that additional research includes correlative studies to identify potential predictive biomarkers for response. Neparidze indicates that there appears to be a subset of long-term responders, making it essential to investigate immune profiling and genomic factors that could predict response to this combination therapy.