Belantamab & A Changing Treatment Landscape
- Belantamab mafodotin is back as an option for patients with relapsed multiple myeloma. The targeted drug was approved, then taken off the market, and has now returned after new studies showed it works well in certain combinations.
- Belantamab is a type of targeted cancer therapy called an antibody-drug conjugate. It is designed to find and attach to a specific protein called BCMA, which is found on myeloma cancer cells.
- Recent studies show that using the drug in combination with proteasome inhibitors led to deeper responses for patients whose myeloma came back after initial treatments.
- An important advantage of belantamab is convenience. It is given as an outpatient infusion, which can make a big difference for patients who live far from major cancer centers or who want to receive treatment closer to home.
- The drug can lead to ocular toxicities, so patients do need to be monitored by an ophthalmologist during treatment.
The drug was previously approved, then taken off the market, and has now returned after new studies showed it works well in certain combinations.
Read MoreWhat Is Belantamab?
Belantamab is a type of targeted cancer therapy called an antibody-drug conjugate. It is designed to find and attach to a specific protein called BCMA, which is found on myeloma cancer cells. Once it attaches, it delivers a small amount of chemotherapy directly into the cancer cell to destroy it.Unlike some newer treatments that use the body’s immune system to attack cancer cells, belantamab works more like a “guided delivery system,” bringing treatment directly to the cancer cells.
Belantamab was first approved based on early studies, but later results were not strong enough when it was used alone, so it was temporarily removed from the market.
“We had it available to use, but it was taken off the market because they didn’t feel that the efficacy as a single-agent was there,” Dr. Alsina explains. “The other thing is that this drug has a particular toxicity, ocular toxicity, so when patients are getting the drug, they need to be seen be an ophthalmologist — but studies were done using this drug in combination with proteasome inhibitors and it actually works very well in that setting.”
Two major studies (DREAMM-7 and DREAMM-8) showed that patients receiving belantamab combinations had deeper responses and longer time before their disease came back compared to older standard treatments.
The drug has now returned as an option for patients with relapsed multiple myeloma.
Who Should Get Belantamab?
There are now many effective treatments for multiple myeloma, including pills, infusions, immune-based therapies, and even CAR T-cell therapy.
Belantamab is most often considered for patients whose myeloma has come back after multiple initial treatments. It may also be helpful for patients who are not be able to travel to major cancer centers for complex treatments like CAR T-cell therapy.
An important advantage of belantamab is convenience. Some treatments require long hospital stays, complex preparation, or close monitoring at specialized cancer centers. Belantamab, in contrast, is given as an outpatient infusion. This can make a big difference for patients who live far from major cancer centers or who want to receive treatment closer to home.
CAR T-cell therapy, Dr. Alsina explains, “is a more involved treatment … you need to go to the academic center, you have to be in the vicinity for a month, and you need a caregiver.”
In comparison, treatments like belantamab can often be given in a more traditional clinic setting.
What To Know About Side Effects
The main side effect of belantamab involves the eyes. Some patients develop blurred vision or dryness because the drug can temporarily affect the surface of the eye.
As Dr. Alsina notes, patients need regular eye exams while receiving treatment. Doctors can carefully adjust doses or pause treatment if needed, and most eye changes improve over time.
Even with this side effect, many patients are able to stay on treatment safely with close monitoring.
Another Option For Relapse
Belantamab is not used for every patient with multiple myeloma. It is one of many options doctors can choose from depending on prior treatments, overall health, and treatment goals.
The return of this drug reflects something larger happening in multiple myeloma care. With many effective options, treatment is becoming more personalized and flexible.
For certain patients, belantamab’s return “opens an opportunity to get a drug that targets a protein that we know is very important to target in myeloma,” Dr. Alsina says. “It’s a drug that is off-the-shelf. You can just prescribe the drug and the patients will get it.”
However, she adds that the best space for belantamab when it comes to treatment sequencing is not yet known.
Belantamab is an example of how quickly multiple myeloma treatment is evolving. It offers another option for patients whose disease has returned, especially when used in combination with other therapies. It is an important part of the growing set of tools doctors now have to manage multiple myeloma.
Questions To Ask Your Doctor
- Is belantamab mafodotin a good option for me?
- How would I be monitored while taking the drug?
- What are my options if ocular side effects become too difficult?
- What order [sequence] do you recommend for multiple myeloma treatments?
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