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    Treatment of Relapsed/Refractory Myeloma (excluding T-cell redirection therapy)

    Category: Treatment of Relapsed/Refractory Myeloma (excluding T-cell redirection therapy)

    DREAMM-7 Study of Belantamab Mafodotin + Bortezomib (V) + Dexamethasone (d) vs Daratumumab + Vd in Relapsed/Refractory Multiple Myeloma: Efficacy in Patients by Subsequent Therapy

    (PA-475) DREAMM-7 Study of Belantamab Mafodotin + Bortezomib (V) + Dexamethasone (d) vs Daratumumab + Vd in Relapsed/Refractory Multiple Myeloma: Efficacy in Patients by Subsequent Therapy

    Friday, September 19, 2025
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    Introduction: In the phase 3 DREAMM-7 trial (NCT04246047), belantamab mafodotin (belamaf) + bortezomib + dexamethasone (BVd) demonstrated significant progression-free survival (PFS) and overall survival (OS) benefits vs daratumumab + bortezomib + dexamethasone (DVd) in patients (pts) with relapsed/refractory multiple myeloma (RRMM) after ≥1 prior line of therapy. Analysis of PFS2, defined as the time from randomization to disease progression or death from any cause after initiation of the next antimyeloma therapy, showed that treatment benefit favoring BVd vs DVd was maintained following subsequent antimyeloma therapy (HR, 0.59; CI, 0.45-0.77). The purpose of this analysis was to understand efficacy in pts who received subsequent anti-CD38 monoclonal antibodies (mAb), pomalidomide, or carfilzomib following treatment with BVd in DREAMM-7.

    Methods: In DREAMM-7, pts were randomized 1:1 to 8 cycles of BVd (3-week cycles) or DVd (weekly in cycles 1-3, every 3 weeks in cycles 4-8), followed by belamaf or daratumumab monotherapy, respectively, in cycle 9+. In this post hoc analysis, time from start of subsequent therapy to progression/death and OS were evaluated in pts in the BVd arm who subsequently received an anti-CD38 mAb (daratumumab or isatuximab), pomalidomide, or carfilzomib as monotherapy or part of a combination regimen.

    Results: Of 494 pts (BVd, N=243; DVd, N=251), 60 (25%) and 38 (15%) were on treatment in the BVd and DVd arms, respectively, at this interim analysis 2 (data cutoff October 7, 2024). Overall, 87 pts (36%) in the BVd arm received subsequent antimyeloma therapies. Common first subsequent therapies after BVd included daratumumab (30/87 [34%]); isatuximab (16/87 [18%]); pomalidomide (26/87 [30%]); and carfilzomib (15/87 [17%]). Subsequent anti-CD38 mAbs were given at 3L+; the most common regimens included isatuximab + pomalidomide + dexamethasone (n=12); daratumumab monotherapy (n=8); daratumumab + lenalidomide + dexamethasone (n=6); and daratumumab + pomalidomide + dexamethasone (n=6). Median time from start of subsequent therapy to progression/death was 14.1, 15.1, and 14.9 months with an anti-CD38 mAb, pomalidomide, and carfilzomib, respectively, after BVd. In the intention-to-treat population, median OS was not reached (NR); 36-month OS rates were 74% with BVd and 60% with DVd. Median OS was NR after any of the aforementioned subsequent therapies following BVd; OS rates at 36 months were 74%, 84%, and 86%, respectively.

    Conclusions: In pts who received anti-CD38 mAbs, pomalidomide, or carfilzomib as first subsequent therapy after BVd, median time from start of subsequent therapy to progression/death was approximately 15 months, showing that subsequent therapy with these agents in the 3L+ was effective post BVd and comparable to median PFS with DVd in the 2L+.




    Funding:      GSK. Drug-linker technology licensed from Seagen Inc.; monoclonal antibody produced using POTELLIGENT Technology licensed from BioWa.