Belantamab mafodotin, bortezomib, and dexamethasone for RRMM in the Japan expansion cohort of the phase 3 DREAMM-7 trial.
Tomoaki Fujisaki, Kohmei Kubo, Yasushi Hiramatsu et al.
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In 30 seconds
This randomized phase 3 trial report describes the Japan expansion cohort of DREAMM-7, comparing belantamab mafodotin, bortezomib, and dexamethasone (BVd) with daratumumab, bortezomib, and dexamethasone (DVd) in 24 patients with relapsed/refractory multiple myeloma and at least one prior therapy. With median follow-up of 19.4 months, median progression-free survival was not reached with BVd versus 11.1 months with DVd; the hazard ratio was 0.40 (95% CI, 0.11-1.52). Response rates were 90.0% and 71.4%, respectively. Ocular adverse reactions were more common with BVd but manageable with dose modification.
Key findings
- Median progression-free survival was not reached with BVd versus 11.1 months with DVd (hazard ratio, 0.40; 95% CI, 0.11-1.52).
- Overall response rates were 90.0% (95% CI, 55.5-99.7) with BVd and 71.4% (95% CI, 41.9-91.6) with DVd.
- Median duration of response was not reached with BVd versus 14.5 months with DVd.
- Ocular adverse reactions were more common with BVd and manageable with dose modification; no new safety signals were reported.
Why it matters
The Japan cohort provides region-specific evidence consistent with the global DREAMM-7 findings that BVd has antimyeloma activity in previously treated RRMM. The progression-free survival estimate favoured BVd, but its confidence interval was wide. The higher frequency of ocular adverse reactions is relevant to weighing the regimen’s observed activity against its safety profile.
What to keep in mind
The Japan expansion cohort included only 24 patients, and the progression-free survival estimate was imprecise, with a wide confidence interval.