Dr Dimopoulos on Efficacy Findings From the DREAMM-8 Trial in Multiple Myeloma

Meletios (Thanos) Dimopoulos, MD, professor, therapeutics, Hematology Oncology, National and Kapodistrian University of Athens School of Medicine, discusses the design of and findings from the phase 3 DREAMM-8 trial (NCT04484623) investigating belantamab mafodotin-blmf (Blenrep), pomalidomide (Pomalyst), and dexamethasone (BPd) in patients with multiple myeloma.

The prospective DREAMM-8 trial randomly assigned patients to receive BPd or pomalidomide, bortezomib (Velcade), and dexamethasone (PVd). Patients were eligible for enrollment if they had received 1 to 3 prior lines of therapy. All patients were required to have received prior treatment with lenalidomide (Revlimid), which Dimopoulos notes is relevant to current clinical practice in this disease, as most patients in this population currently receive lenalidomide maintenance therapy. In DREAMM-8, 23% and 27% of patients in the BPd and PVd arms, respectively, had also received prior treatment with the anti-CD38 monoclonal antibody daratumumab (Darzalex).

Progression-free survival (PFS) served as the primary end point of the trial; this end point was met, with patients in the BPd arm achieving a median PFS that was not reached vs 12.7 months (95% CI, 9.1-18.5) among those in the PVd arm (HR, 0.52; 95% CI, 0.37-0.73; 2-sided P < .001). This PFS improvement with BPd was both statistically significant and clinically meaningful, Dimopoulos highlights. Additionally, responses were deeper in the BPd arm; the overall response rate was 77% (95% CI, 70%-84%) in this arm vs 72% (95% CI, 64%-79%) in the control arm. The respective complete response (CR) or better rates were 40% (95% CI, 32%-48%) and 16% (95% CI, 11%-23%). Moreover, 24% (95% CI, 17%-31%) of patients in the BPd arm achieved a CR or better plus minimal residual disease negativity vs 5% (95% CI, 2%-10%) of those in the PVd arm. The estimated percentages of patients with a duration of response of 12 months were 79% (95% CI, 71%-86%) in the BPd arm vs 61% (95% CI, 50%-70%) in the PVd arm.