What Is Blenrep?
Blenrep® (belantamab mafodotin-blmf) is the first antibody-drug conjugate (ADC) approved by the FDA for the treatment of myeloma. Blenrep is the combination of a monoclonal antibody that binds to the B-cell maturation antigen (BCMA) on the surface of myeloma cells coupled with monomethyl auristatin F (MMAF), a drug that can kill myeloma cells. When the monoclonal antibody portion of Blenrep attaches to BCMA, Blenrep enters the cell and releases MMAF, which leads to cell death. The antibody part of the ADC attracts your body’s own immune system to recognize myeloma cells and attack them.
Who Is a Candidate for Blenrep?
Blenrep is indicated for patients with relapsed (myeloma that has come back after prior treatment) or refractory myeloma (myeloma that is no longer responsive to prior treatments) who have received at least four prior therapies, including
- an anti-CD38 monoclonal antibody (e.g., Darazlex),
- a proteasome inhibitor (e.g., Velcade), and
- an immunomodulatory drug (e.g, Revlimid, Pomalyst, or Thalomid).
What Are the Dose and Schedule of Blenrep?
Blenrep is given as an intravenous infusion once every 3 weeks, over approximately 30 minutes each time, at a dose of 2.5 mg/kg, until your myeloma progresses or if the side effects can no longer be tolerated.
What Are the Possible Side Effects of Blenrep?
Your doctor can anticipate and manage the possible side effects. If necessary, your doctor may interrupt or reduce your dose, or stop your treatment with Blenrep. You must also immediately report to your doctor any of the following signs or symptoms:
- Ocular (eye) problems
Blenrep can cause changes to the surface of your eye that can lead to dry eyes, blurred vision, worsening vision, severe vision loss, and corneal ulcer. Your doctor will conduct eye examinations prior to your first dose of Blenrep, prior to each subsequent dose, and promptly for worsening symptoms. Because of the risk of eye problems, Blenrep is only available through a restricted program called the Blenrep REMS.
- Thrombocytopenia (a decrease in platelets)
Low levels of platelets (a type of blood cell that helps your blood clot) can lead to bleeding. Your doctor will monitor your platelet counts before you begin treatment with Blenrep and during treatment as needed. Your doctor may choose to treat thrombocytopenia with medication or with platelet infusion.
- Infusion-related reactions
Depending on the severity of infusion-related reactions, your doctor may give you medication prior to your future infusions, or may slow down or stop your treatment with Blenrep.
Pregnancy, Lactation, and Reproductive Potential
Blenrep may impair fertility, cause fetal harm when administered to pregnant women, and result in serious adverse reactions in the breastfed child. Females of reproductive potential and males with female partners of reproductive potential must consult their doctor prior to initiating treatment.