Dr. Finn on the Utility of Belantamab Mafodotin in Late Relapsed Multiple Myeloma

Laura Finn, MD, associate program director, Hematology/Oncology Fellowship Program, associate program director, Bone Marrow Transplant, hematology research chair, Precision Cancer Therapies Program, Ochsner Health, discusses the utility of belantamab mafodotin-blmf (Blenrep) in late relapsed multiple myeloma.

Belantamab mafodotin is a humanized antibody-drug conjugate targeted against BCMA, which is found primarily on malignant plasma cells but not on normal cells in the hematopoietic system, Finn explains. The agent is covalently linked to monomethyl auristatin F.

The mechanism of action of belantamab mafodotin enables direct cytotoxicity, as well as the recruitment of macrophages and natural killer cells for antibody-dependent cellular phagocytosis of myeloma cells, Finn says. This is different from other therapies, such as bispecific T-cell engagers (BiTEs) and CAR T-cell therapies, which capitalize on T cells to target myeloma cells. These types of cellular therapies confer toxicities like cytokine release syndrome and neurotoxicity. Although belantamab mafodotin is not associated with these toxicities, the agent can cause ocular toxicities, Finn adds.

Notably, belantamab mafodotin is more readily available outside of cellular therapy centers compared with BiTEs or CAR T-cell therapies. Belantamab mafodotin was granted accelerated approval from the FDA in August 2020 for the treatment of patients with relapsed/refractory multiple myeloma who have received at least 4 prior therapies, including a CD38-directed monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent. Because of the risk of ocular toxicity, the agent is only available for use through a Risk Evaluation and Mitigation Strategy program, Finn concludes.