Belantamab & CAR T-Cell Therapy: Key ASH 2024 Updates on Early Myeloma Relapse 

Dr. Joseph Mikhael:

In my overview of the great research presented at ASH this year, I commented on five key areas of research. Let's dive into number three: early relapse. To learn more about the other areas that we're exploring from ASH, please subscribe to our YouTube channel, and you can learn about the other four areas that I highlight.

We know that unfortunately almost every patient with multiple myeloma will have a relapse, meaning their disease will come back after it's initially treated. But thankfully, we're developing better and better therapies for our patients at that earlier first relapse typically is we define it as one to three prior lines of therapy.

The area of particular interest at ASH this year was the drug belantamab mafodotin. This was a drug that was removed from the market a few years ago because of a negative clinical trial, but now we're seeing updates from two very important trials called the DREAMM-7 and the DREAMM-8 trial, which interestingly were studies that compared three drugs versus three drugs.

Often we have clinical trials that compare more versus less, but here it was three versus three using belantamab with pomlidomide and dexamethasone, or belantamab with bortezomib and dexamethasone. And in both trials we saw considerable benefit of adding belantamab not only in progression-free survival, but even in overall survival, and we think this is going to herald the reuse of this drug back in the clinic. It is going to be reviewed by the FDA, and we anticipate potentially hearing in the middle of 2025 if we can bring this drug back into the clinic.

And I think it's particularly important 'cause in a complicated disease like myeloma that have patients of various backgrounds of different ages in different geographical settings, we want options for our patients. And belantamab provides an option that is a little bit easier to administer. That doesn't require an academic center, it doesn't require T-cell collection and doesn't require intense monitoring as we see with bispecific antibodies.

It does, however, have some issues that we need to sort out like some of the eye toxicities, but we're becoming much better at doing that, especially by giving the drug less frequently. I'll also give a quick shout out to the earlier use of CAR T-Cell therapy as we saw updates in certain studies that evaluated CAR T-Cell therapy earlier.

Arguably CAR T-cell therapy has been the most intense, but also most prolific agent that we have in multiple myeloma with the deepest and the most durable responses. And we know that we can provide this to patients as soon as first relapse.

So again, these are exciting times in multiple myeloma with so much great work being done in that early relapse setting providing more durable responses for our patients.