Belantamab Mafodotin Plus Pomalidomide-Dexamethasone Demonstrates Efficacy Among Patients With Triple Class Exposed/Refractory Multiple Myeloma

Post-Hoc Subgroup Analysis of the ALGONQUIN Trial

According to a post-hoc subgroup analysis of the ALGONQUIN trial, patients with relapsed/refractory (R/R) multiple myeloma (MM) with triple class exposed/refractory (TCE/TCR) disease treated with belantamab mafodotin plus pomalidomide-dexamethasone (belamaf-Pd) achieved high clinical response rates with durable remissions.

“Given the early use of triplet and quadruplet regimens, most patients with MM will be exposed and/or refractory to [proteosome inhibitors], [immunomodulatory drugs], and anti-CD38 [monoclonal antibodies] after first- or second-line treatment. Effective treatment for this group of TCE/R patients is crucial,” stated lead study author Arleigh McCurdy, MD, MHA, FRCPC, Ottawa Hospital Research Institute, Ontario, Canada, and colleagues.

In this analysis, investigators evaluated the overall response rate (ORR), progression-free survival (PFS), duration of response (DOR), overall survival (OS), and adverse events in patients with multiple myeloma who were TCE (exposed to a proteosome inhibitor, lenalidomide, and an anti-CD38 monoclonal antibody) and/or TCR (refractory to a proteosome inhibitor, lenalidomide, and anti-CD38 monoclonal antibodies), defined as disease that is non-responsive to therapy or progression during or within 60 days of drug administration.

Of the 99 patients treated in the ALGONQUIN trial, 69 exhibited TCE disease and 56 exhibited TCR disease. These patients were included in the analysis and had a median of 3 prior lines of therapy. Results demonstrated an ORR of 86.4% in patients with TCE disease and 84.9% in patients with TCR disease, displaying ≥ very good partial response rates of 64% and 68% respectively. The median PFS was 18.3 months in patients with TCE and 19.6 months in patients with TCR, with overall survival not yet reached and 34.4 months, respectively for patients with TCE and TCR.

Furthermore, no new safety signals were identified. The most common grade ≥ 3 adverse events were keratopathy (48%), decreased visual acuity (42%), neutropenia (36%), thrombocytopenia (27%), and infection (25%).

“In summary, patients with TCE/TCR disease treated with belamaf-Pd on the ALGONQUIN trial experienced clinical benefits that are markedly superior to those reported with real-life [standard of care] therapies and competitive with other BCMA agents including the bispecifics and ide-cel,” concluded Dr McCurdy and colleagues.

“These data support the use of belamaf-Pd as a highly effective therapy to address the unmet need of particularly challenging [R/R MM] patient population,” they added.

Source:

McCurdy A, Reece D, Louzada M, et al. Belantamab mafodotin, pomalidomide, and dexamethasone for triple class exposed/refractory relapsed multiple myeloma: a subgroup analysis of the ALGONQUIN trial. Blood Cancer J. Published online September 11, 2024. doi: 10.1038/s41408-024-01135-2