Dr Neparidze on the Implications of Early Data for Belantamab Mafodotin Plus Elotuzumab in R/R Myeloma

Natalia Neparidze, MD, associate professor, internal medicine (hematology), research leader, Myeloma Program, Yale University School of Medicine, discusses the clinical implications of data from the phase 1b/2 Bela-Elo trial (NCT05002816), which evaluated the safety, tolerability, and preliminary efficacy of the combination of belantamab mafodotin-blmf (Blenrep) and elotuzumab (Empliciti) in heavily pretreated patients with relapsed/refractory multiple myeloma. She also explains the next steps for this study.

 showed that no dose-limiting toxicities were reported in the 10 evaluable patients treated during the study. Any-grade adverse effects consisted of neutropenia (n = 2), anemia (n = 1), thrombocytopenia (n =2), lymphopenia (n = 3), pulmonary infections (n = 3), nausea/vomiting (n = 2), and ocular keratopathy (n = 4). No grade 3 or higher ocular keratopathy occurred, and all these events resolved following discontinuation or dose reduction of belantamab mafodotin.

Regarding efficacy, the overall response rate was 40%, which was comprised of 4 patients achieving a partial response (PR). Three additional patients experienced stable disease. Notably, 2 of 4 patients who received a prior BCMA-directed therapy had a PR with median durations of response of 19 months and 9 months, respectively.

The safety and tolerability profile of this combination has been favorable thus far, Neparidze explains, adding that this regimen can also be administered in an outpatient setting. Given the early efficacy observed in patients with heavily pretreated relapsed/refractory multiple myeloma, including those who received prior BCMA-targeted therapy, the data suggest that belantamab mafodotin plus elotuzumab may represent a potential therapeutic option for patients who have exhausted other treatment options, she continues. 

Regarding future directions, Neparidze explains that additional research includes correlative studies to identify potential predictive biomarkers for response. Neparidze indicates that there appears to be a subset of long-term responders, making it essential to investigate immune profiling and genomic factors that could predict response to this combination therapy.

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Natalia Neparidze, MD, discusses clinical implications and future of belantamab mafodotin and elotuzumab in heavily pretreated, relapsed/refractory multiple myeloma.

Dr Neparidze on Belantamab Mafodotin Plus Elotuzumab in R/R Myeloma

Natalia Neparidze, MD, associate professor, internal medicine (hematology), research leader, Myeloma Program, Yale University School of Medicine, discusses findings from the phase 1b/2 Bela-Elo trial (NCT05002816) evaluating the safety, tolerability, and preliminary efficacy of the combination of belantamab mafodotin-blmf (Blenrep) and elotuzumab (Empliciti) in heavily pretreated patients with relapsed/refractory multiple myeloma.

The trial enrolled patients with triple-class refractory multiple myeloma, including those with progression following prior BCMA-targeted therapies. Notably, 8 of the 10 patients enrolled thus far were also penta-drug refractory, Neparidze explains. The median age of enrolled patients was 66.5 years (range, 59-79), and patients received a median of 5 prior lines of therapy (range, 2-8). Notably, 3 patients had extramedullary disease.

 showed that no dose-limiting toxicities were observed in the 10 evaluable patients treated during the study. Any-grade adverse effects included neutropenia (n = 2), anemia (n = 1), thrombocytopenia (n =2), lymphopenia (n = 3), pulmonary infections (n = 3), nausea/vomiting (n = 2), and ocular keratopathy (n = 4). Notably, all instances of ocular keratopathy were grade 1 or 2 and resolved with discontinuation or dose reduction of belantamab mafodotin.

Efficacy data showed that a partial response (PR) was observed in 40% of patients, and stable was reported in another 30%. Notably, 2 of the 4 patients who received prior BCMA-directed therapies achieved a PR, including 1 patient who had a duration of response of 19 months, Neparidze says. In the patients who experienced stable disease, the outcomes appeared durable, which could be clinically meaningful for a heavily pretreated patient population, Neparidze adds.

Further directions for this research included correlative studies to evaluate genomic and immune profiles to identify potential predictive biomarkers of response for this combination. The efficacy and safety data derived from Bela-Elo thus far have been encouraging, Neparidze concludes.

Natalia Neparidze, MD, discusses combining belantamab mafodotin with elotuzumab in patients with RRMM.

Natalia Neparidze, MD

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Dr Neparidze on the Implications of Early Data for Belantamab Mafodotin Plus Elotuzumab in R/R Myeloma

Dr Neparidze on Belantamab Mafodotin Plus Elotuzumab in R/R Myeloma