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Drugs Fut 2020, 45(12): 865
ISSN 0377-8282
Copyright 2020 Clarivate Analytics
CCC: 0377-8282
DOI: 10.1358/dof.2020.45.12.3205279
Belantamab mafodotin. Antibody-drug conjugate targeting B-cell maturation antigen (BCMA), Treatment of multiple myeloma
Routledge, D.
Multiple myeloma is a relatively uncommon hematological malignancy with a median age of diagnosis of approximately 65 years of age. It is still considered incurable, despite the introduction of novel agents. Belantamab mafodotin (belamaf, GSK-2857916, Blenrep) is a first-in-class humanized IgG1 antibody-drug conjugate linked to monomethyl auristatin F (MMAF) that binds to B-cell maturation antigen (BCMA). Belamaf's multimodel mechanism of action includes apoptosis and release of immunogenic cell death markers, antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis by immune effector cells. It is largely intact in the plasma with a low volume of distribution, undergoing renal and hepatobiliary clearance. In vitro studies have not demonstrated inhibition or induction of cytochrome P450. Common toxicities include thrombocytopenia and corneal events. Several phase I to III studies have utilized belamaf in relapsed or refractory myeloma patients demonstrating good response rates in heavily pretreated patients. Additionally, further trials are ongoing looking at novel drug combinations with belamaf or as part of combination regimens in newly diagnosed patients. In conclusion, belamaf is a promising novel antimyeloma treatment targeting BCMA with good response rates in a difficult patient group with little other treatment options available.

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