Abstract
Belantamab mafodotin (belamaf) demonstrated deep and durable responses in patients with heavily pretreated relapsed or refractory multiple myeloma (RRMM) in DREAMM-2 (NCT03525678). Corneal events, specifically keratopathy (including superficial punctate keratopathy and/or microcyst-like epithelial changes (MECs), eye examination findings with/without symptoms), were common, consistent with reports from other antibody–drug conjugates. Given the novel nature of corneal events in RRMM management, guidelines are required for their prompt identification and appropriate management. Eye examination findings from DREAMM-2 and insights from hematology/oncology investigators and ophthalmologists, including corneal specialists, were collated and used to develop corneal event management guidelines. The following recommendations were formulated: close collaboration among hematologist/oncologists and eye care professionals is needed, in part, to provide optimal care in relation to the belamaf benefit–risk profile. Patients receiving belamaf should undergo eye examinations before and during every treatment cycle and promptly upon worsening of symptoms. Severity of corneal events should be determined based on corneal examination findings and changes in best-corrected visual acuity. Treatment decisions, including dose modifications, should be based on the most severe finding present. These guidelines are recommended for the assessment and management of belamaf-associated ocular events to help mitigate ocular risk and enable patients to continue to experience a clinical benefit with belamaf.Video Summary8tfusA9hgR4WGduPotvDZf
Highlights
In recent decades, significant advancements have been made in the management of multiple myeloma (MM), with several new treatments approved and novel classes of agents being investigated[1,2]
Keratopathy and visual acuity (KVA) scale development Given the association of ocular events with monomethyl auristatin F (MMAF)
The risk of keratopathy (MECs) does not appear to decrease over time and these events will recur with repeated dosing, so it is imperative to gain a better understanding of how to optimize corneal event management
Summary
Significant advancements have been made in the management of multiple myeloma (MM), with several new treatments approved and novel classes of agents being investigated[1,2]. Patients with MM are treated with three major drug classes: immunomodulatory agents, proteasome inhibitors (PIs), and anti-CD38 monoclonal. MM (RRMM), patients who become refractory to anti-CD38 mAbs (median overall survival (OS): 6–9 months)[1,2,4]. B-cell maturation antigen (BCMA) is a receptor expressed on the cell surface of late-stage B cells and plasma cells[3]. Considering the selective expression of the BCMA receptor and its impact on late-stage B cells, BCMA represents an ideal therapeutic target for plasma cell malignancies[3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
