Belantamab Mafodotin: Advancing Treatment Paradigms in Relapsed/Refractory Multiple Myeloma

Author(s): Syed Owais Akhtar, Bibek Gautam, Kuchi Deekshitha, Adees Wirtan Sarkees Bedros, Fiza Arif, Iqra Saleem, Laiba Arif, Nadir Akhtar

Belantamab Mafodotin (Belamaf) has emerged as a critical therapeutic advancement for patients with relapsed/refractory multiple myeloma (RRMM), addressing the unmet need for novel treatments in this patient population. Multiple myeloma, a malignant proliferation of plasma cells, often progresses to relapsed/refractory stages where standard treatments become ineffective, resulting in poor prognosis and significant morbidity. Belamaf, a B-cell maturation antigen (BCMA)- targeted antibody-drug conjugate, introduces a novel mechanism by delivering a cytotoxic agent specifically to myeloma cells, thereby minimizing off-target effects. The pivotal clinical trials, including DREAMM-2, have demonstrated substantial efficacy, with impressive overall response rates and prolonged progression-free survival, alongside a manageable safety profile dominated by adverse events such as keratopathy and thrombocytopenia. The U.S. Food and Drug Administration (FDA) approved Belamaf for RRMM patients who have received at least four prior therapies, including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent. Comparative analyses indicate that Belamaf offers distinct advantages over existing treatment modalities, such as immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies. Nevertheless, challenges persist, including high treatment costs, limited accessibility, and the management of associated toxicities. Future research directions focus on optimizing patient selection, enhancing combination therapies, and streamlining the manufacturing process. The integration of Belamaf into clinical practice underscores the importance of multidisciplinary care and patient education, signifying a hopeful advancement in the treatment landscape of RRMM through continued innovation and collaborative efforts.