Practical Guidance on the Clinical Management of Belantamab Mafodotin for Patients With Relapsed/Refractory Multiple Myeloma: Recommendations From the Middle East and North Africa Expert Panel

Abstract

Multiple myeloma (MM) remains a substantial cause of mortality in the Middle East and North Africa, with incidence rising in the region. MM is challenging to treat because many people relapse and/or become refractory to standard of care. Additional challenges in the Middle East and North Africa region include reduced access to newer therapies, resulting in poorer outcomes than in other regions. Belantamab mafodotin-a first-in-class antibody-drug conjugate targeting B-cell maturation antigen-has shown significant efficacy in the recent DREAMM-7 and DREAMM-8 phase 3 trials for patients with relapsed/refractory MM. However, participants experienced a high incidence of ocular adverse events, due to the off-target effects of monomethyl auristatin F, a microtubule inhibitor responsible for belantamab mafodotin's antimyeloma activity. Belantamab mafodotin is currently under regulatory review in several countries; thus, healthcare providers need specific regional guidance to manage these ocular side effects. A panel of 13 experts in hematology/oncology and ophthalmology from Turkey, Egypt, Saudi Arabia, the United Arab Emirates and Kuwait developed these practical recommendations. The recommendations, formulated through detailed discussions, evidence review and clinical experience, focused on several themes around identification and management of ocular adverse events with a specific emphasis on prevention of severe ocular events.

Keywords: Dose modification; Dry eye; Expert consensus; Ocular adverse events; Ocular toxicity.