Ask The Nurse // 2nd December 2020
Many myeloma patients, their friends and family like to keep up with the latest myeloma research and are particularly interested in potential new treatments. These queries are more common when patients are assessing their future treatment options, are considering taking part in a clinical trial or when a new treatment has been in the news.
A drug that is starting to come up in conversations more often is belantamab mafodotin (Blenrep). This treatment recently received a conditional licence from the European Medical Association (EMA) for use in relapsed and refractory myeloma and is available through several clinical trials in the UK.
In this month’s blog, we have decided to tell you more about belantamab mafodotin and how it works.
What is belantamab mafodotin?
Belantamab mafodotin is a new type of drug called an antibody-drug conjugate. It is being investigated as a single drug (monotherapy) and in several combinations for the treatment of myeloma. It is the first anti-myeloma drug to be licensed by the EMA which uses BCMA to target myeloma cells.
What is an antibody-drug conjugate?
Antibody-drug conjugates have two parts:
- A monoclonal antibody which directs the drug to cancer cells. It is designed to find and attach to a specific protein found on the surface of cancer cells. For belantamab mafodotin, it targets a protein called BCMA, myeloma cells have a lot of BCMA on their surface, while healthy cells have very little
- A chemotherapy drug to kill cancer cells. This part of the drug only becomes active after the antibody has attached to the cancer cell so it can specifically target them
How is belantamab used?
Belantamab mafodotin is usually given by infusion (drip) into a vein once every three weeks, and the dose depends on your body weight. Treatment is given until there is no benefit (the myeloma shows signs of becoming active) or the side effects become unacceptable.
Whilst patients are receiving belantamab mafodotin they will be advised to use preservative-free artificial tears at least four times a day and have their eyes checked before and at times throughout this line of treatment. This is because damage to the cornea (the transparent layer in front of the eye that covers the pupil and iris) is one of the known side effects of belantamab mafodotin.
What evidence exists to support the use of belantamab mafodotin?
The main clinical evidence to support the use of belantamab mafodotin in relapsed and refractory myeloma patients comes from a trial called DREAMM-2.
The trial involving 196 patients showed that belantamab mafodotin was effective in patients whose myeloma had returned and did not respond to other treatments. Almost a third of patients (32%) responded to treatment and on average, this lasted for 11 months.
Is belantamab mafodotin available in the UK?
Belantamab mafodotin is not routinely available through the NHS in the UK. However, some myeloma patients may be able to access it through private healthcare, as part of a clinical trial or via an expanded access (compassionate use) programme.
At the moment, four belantamab mafodotin clinical trials are recruiting in the UK. One trial called DREAMM-3 is evaluating belantamab mafodotin as a monotherapy. The other trials (DREAMM-6, DREAMM-7 and DREAMM-9) are looking at the effectiveness of belantamab based combinations. These trials are not suitable for all myeloma patients because there are specific criteria for joining each of these trials. You can find out more about them on our “Myeloma Trial Finder”.
Multiply relapsed and/or refractory patients who are not eligible for a clinical trial may be able to access belantamab mafodotin through an expanded access (compassionate use) programme which has been set up by the drug manufacturer. If your haematologist thinks this is an option and you meet the criteria for the programme, they can put in an access request.
For more information download the “Belantamab mafodotin Horizons Infosheet”.
If you have any questions about myeloma treatments, you can get in touch with us through the Infoline (0800 980 3332 (UK) or 1800 937 773 (Ireland)) or the Ask The Nurse email service.
The Myeloma UK Information Specialist Team