PACUPod: Oncology

Belantamab mafodotin plus bortezomib and dexamethasone in patients with relapsed or refractory multiple myeloma DREAMM7 updated overall survival analysis from a global randomised open label phase 3 trial summary

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{
"episode_title": "DREAMM-7 Updated Overall Survival: Belantamab Mafodotin with BVd in Relapsed/Refractory Multiple Myeloma",
"podcast_show": "PACUPod",
"description": "In this episode of PACUPod, we review the updated overall survival results from the DREAMM-7 phase 3 trial, testing belantamab mafodotin in combination with bortezomib and dexamethasone (BVd) versus daratumumab, bortezomib, and dexamethasone (DVd) in relapsed or refractory multiple myeloma. We discuss the significant OS improvement (hazard ratio 0.58; p=0.0002), deeper responses with higher MRD negativity, longer duration of response, and safety considerations including thrombocytopenia and ocular keratopathy, along with monitoring strategies. We also cover clinical implications, limitations (notably underrepresentation of Black patients), and future directions including DREAMM-8 and sequencing with other BCMA-targeted therapies.",
"study_title": "Belantamab mafodotin plus bortezomib and dexamethasone in RRMM: DREAMM-7 updated OS analysis",
"trial_design": "Global, randomized, open-label phase 3 trial",
"trial_details": {
"n_patients": 494,
"population": "Relapsed or refractory multiple myeloma after at least one prior line",
"exclusions": ["prior anti-BCMA therapy", "significant ocular disease"],
"primary_endpoint": "Progression-free survival",
"update_endpoints": ["Overall survival", "Minimal residual disease negativity", "Duration of response", "Safety"]
},
"interventions": {
"experimental_arm": "Belantamab mafodotin 2.5 mg/kg IV q3 weeks + bortezomib + dexamethasone",
"comparator_arm": "Daratumumab + bortezomib + dexamethasone"
},
"key_results": {
"overall_survival": {
"hazard_ratio": 0.58,
"p_value": 0.0002,
"median_OS": {
"BVd": "not reached",
"DVd": "34.5 months"
}
},
"MRD_negativity": {
"BVd": "25%",
"DVd": "10%"
},
"duration_of_response": {
"BVd": "40.8 months",
"DVd": "17.8 months"
}
},
"safety": {
"thrombocytopenia": {
"BVd": "56%",
"DVd": "35%"
},
"ocular_events": {
"keratopathy": "about 40%",
"nature": "mostly low-grade and reversible with interruptions/dose adjustments"
},
"monitoring_recommendations": "Regular ophthalmologic monitoring; manage with dose modifications and treatment interruptions"
},
"clinical_implications": [
"BVd is a promising triplet regimen for RRMM after ≥1 prior therapy, especially lenalidomide-refractory",
"Ocular toxicity requires monitoring and management",
"Safety profile compared to T-cell redirecting therapies may be favorable",
"Supports belantamab-based triplets as a new standard of care in RRMM"
],
"limitations": [
"Underrepresentation of Black patients",
"Long-term safety and cumulative toxicity unknown",
"Open-label design despite independent efficacy assessment"
],
"future_directions": [
"DREAMM-8 (belantamab with pomalidomide/dexamethasone)",
"Sequencing with other BCMA-targeted therapies (CAR-T, bispecifics)",
"Head-to-head comparisons of belantamab-based triplets"
],
"references": [
"Hungria et al. Lancet Oncology; DREAMM-7 updated OS analysis"
],
"keywords": [
"DREAMM-7",
"belantamab mafodotin",
"BVd",
"DVd",
"bortezomib",
...more
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PACUPod: OncologyBy Pharmacy & Acute Care University