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Randomized Controlled Trial
. 2024 Sep 11;14(1):155.
doi: 10.1038/s41408-024-01135-2.

Belantamab mafodotin, pomalidomide, and dexamethasone for triple class exposed/refractory relapsed multiple myeloma: a subgroup analysis of the ALGONQUIN trial

Arleigh McCurdy  1 , Donna Reece  2 , Martha L Louzada  3 , Darrell White  4 , Stephen Parkin  5 , Michael P Chu  6 , Rami Kotb  7 , Hira Mian  8 , Ibraheem Othman  9 , Jiandong Su  10 , Aniba Khan  10 , Engin Gul  10 , Suzanne Trudel  2
Affiliations
Randomized Controlled Trial

Belantamab mafodotin, pomalidomide, and dexamethasone for triple class exposed/refractory relapsed multiple myeloma: a subgroup analysis of the ALGONQUIN trial

Arleigh McCurdy et al. Blood Cancer J. .

Abstract

Given the early use of triplet and quadruplet regimens, most patients with multiple myeloma (MM) will be exposed and/or refractory to PIs, IMiDs, and anti-CD38 mAbs after first- or second-line treatment. Effective treatment for this group of triple class exposed/refractory (TCE/R) patients is crucial. Here we present a post-hoc subgroup analysis of TCE/R patients treated on the ALGONQUIN study of belantamab mafodotin plus pomalidomide-dexamethasone (belamaf-Pd) for relapsed MM. Of the 99 patients treated on the ALGONQUIN study, 69 were TCE and 56 were TCR and were included in this analysis. Patients had a median of three prior lines of therapy. The ORR was 86.4% in TCE patients and 84.9% in TCR patients, with ≥ very good partial response rates of 64% and 68% respectively. The median progression free survival was 18.3 months in TCE patients and 19.6 months in TCR patients, with overall survival not yet reached and 34.4 months, respectively for TCE and TCR patients. No new safety signals were identified. The most common Grade ≥ 3 AEs were keratopathy (48%), decreased visual acuity (42%), neutropenia (36%), thrombocytopenia (27%), and infection (25%). In this subgroup analysis of the ALGONQUIN study, patients with TCE/TCR disease treated with belamaf-Pd achieved high clinical response rates with durable remissions, comparable to other novel therapeutics in this space.

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Conflict of interest statement

The authors declare the following competing interests: AM received honoraria from Celgene, Janssen, Amgen, Takeda, Sanofi, and GSK. DR received research funding and honoraria from, and is on the advisory board of, Janssen, BMS, and Takeda; received research funding from Millennium Pharmaceuticals; and received honoraria from Amgen, Sanofi, and GSK. ML received research support from BMS/Celgene and Janssen; and honoraria from BMS/Celgene, Janssen, Gilead, AbbVie, AstraZeneca, and Takeda. SP received consultancy honoraria from Janssen, BMS, FORUS, and Apotex; study funding from GSK; and funding from BMS. DW received honoraria from Amgen, Antengene, BMS, FORUS Therapeutics, GSK, Janssen, Karyopharm, Pfizer, Sanofi, and Takeda. MC received research support from BMS/Celgene and Janssen; and honoraria from BMS/Celgene, Janssen, Gilead, AbbVie, AstraZeneca, and Takeda. RK received honoraria from Akcea Therapeutics, Amgen, BMS, Janssen, Merck, Sanofi, Celgene, Pfizer, and Takeda; received research funding from Merck and Sanofi; and is a current equity holder in the private company Karyopharm. HM received advisory fees from Janssen, Takeda, Amgen, Pfizer, BMS, FORUS, and Sanofi; received research funding from Janssen; and is supported by the early career award from Hamilton Health Sciences. IO participated in advisory boards for and received honoraria from Amgen, BMS, Celgene, FORUS Therapeutics, Janssen, Pfizer, Sanofi-Genzyme, and Takeda; and received research funding from Janssen. JS, AK, and EG are employees of CMRG. ST received grant support from GSK, Bristol Myers Squibb (BMS), Janssen, Pfizer, Amgen, Roche, and Genentech; consulting fees from BMS, GSK, and Roche; and honoraria from BMS, Janssen, Amgen, Sanofi, and Pfizer.

Figures

Fig. 1
Fig. 1. CONSORT flow diagram for TCR/TCE patients enrolled onto the Algonquin Study.
AE adverse event, belamaf-Pd belantamab mafodotin, pomalidomide and dexamethasone, Q8W every 8 weeks, RP2D recommended Part 2 dose. *Includes 8 from the dose escalation treated with 2.5 mg/kg Q8W.
Fig. 2
Fig. 2. Kaplan–Meier curves for median PFS, DOR and OS by overall and RP2D.
a PFS, DOR and OS KM curves for all TCE (n = 69) and all TCR (n = 56). b PFS, DOR and OS for RP2D patients (n = 41). CI confidence interval, Est estimated, DOR duration of response, HR hazard ratio, KM Kaplan–Meir, NE not estimable, OS overall survival, PFS progression-free survival, RP2D recommended part 2 dose, TCE triple-class exposed, TCR triple-class refractory.
See this image and copyright information in PMC

References

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