University of Kansas Medical Center, Kansas City, KA.
Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC; US Myeloma Research Consortium (USMRC, Kansas City, KA.
Clin Lymphoma Myeloma Leuk. 2022 Dec;22(12):912-919. doi: 10.1016/j.clml.2022.08.003. Epub 2022 Aug 15.
Triple-class relapsed/refractory multiple myeloma (RRMM) has a poor prognosis. This study analyzed the clinical outcomes of Belantamab mafadotin in combination with dexamethasone (Bd) in triple-class RRMM.
We identified 35 patients with triple-class RRMM who received Bd at the University of Kansas from October 2019 to November 2021.
The median age was 66 years (42-85) and the median prior lines of therapy was 5 (3-15). Nineteen (54%) patients had R-ISS stage III disease, 15 (43%) patients had high-risk cytogenetics, and 15 patients (43%) had extramedullary disease (EMD). Eight patients received prior BCMA-targeted therapy. Overall response rate (ORR) was 43%, with 23% achieving very good partial response and better. At a median follow up of 10.7 months, the median progression-free survival and survival were 4.9 and 10.7 months, respectively. The most common adverse event was keratopathy, which occurred in 30 (86%) patients. Twenty-four patients required dose reduction or delay due to keratopathy. Other common toxicities included anemia (83%), thrombocytopenia (80%), neutropenia (34%), and elevated liver function tests (51%).
Our analysis shows Bd has good activity in triple-class RRMM. Keratopathy remains a challenging AE and the leading cause of dose reduction, delay and treatment cessation.
三药难治/复发多发性骨髓瘤(RRMM)预后较差。本研究分析了贝兰他单抗联合地塞米松(Bd)在三药难治 RRMM 中的临床疗效。
我们在堪萨斯大学共纳入了 35 例自 2019 年 10 月至 2021 年 11 月期间接受 Bd 治疗的三药难治 RRMM 患者。
中位年龄为 66 岁(42-85 岁),中位治疗线数为 5 线(3-15 线)。19 例(54%)患者为 R-ISS Ⅲ期疾病,15 例(43%)患者存在高危细胞遗传学异常,15 例(43%)患者存在髓外疾病(EMD)。8 例患者接受过 BCMA 靶向治疗。总缓解率(ORR)为 43%,其中 23%的患者达到了非常好的部分缓解及以上。中位随访 10.7 个月时,中位无进展生存期和总生存期分别为 4.9 个月和 10.7 个月。最常见的不良反应是角膜病变,发生率为 30 例(86%)。由于角膜病变,24 例患者需要减少剂量或延迟治疗。其他常见的毒性包括贫血(83%)、血小板减少(80%)、中性粒细胞减少(34%)和肝功能检查异常(51%)。
我们的分析表明 Bd 在三药难治 RRMM 中具有良好的疗效。角膜病变仍然是一种具有挑战性的不良反应,也是导致剂量减少、延迟和治疗终止的主要原因。