Multiple myeloma - combination treatment with pomalidomide and dexamethasone

Active Ingredient: Belantamab mafodotin

Indication for Belantamab mafodotin

Population group: only adults (18 years old or older)
Therapeutic intent: Curative procedure

Belantamab mafodotin is indicated in adults for the treatment of relapsed or refractory multiple myeloma in combination with pomalidomide and dexamethasone in patients who have received at least one prior therapy including lenalidomide.

For this indication, competent medicine agencies globally authorize below treatments:

2.5 mg/kg once for 4 weeks and thereafter 1.9 mg/kg administered once every 4 weeks

For:

Dosage regimens

Intravenous, 2.5 milligrams belantamab mafodotin per kilogram of body weight, one dose, over the duration of 4 weeks. Afterwards, intravenous, 1.9 milligrams belantamab mafodotin per kilogram of body weight, once every 4 weeks.

Detailed description

Recommended supportive care

Patients should have an ophthalmic examination (including visual acuity and slit lamp examination) performed by an eye care professional before each of the first 4 doses of belantamab mafodotin treatment, and as clinically indicated thereafter.

Posology

Administration of belantamab mafodotin is to be continued according to the recommended schedule until disease progression or unacceptable toxicity. Belantamab mafodotin is administered in combination with other treatments (see Table 1). For other medicinal products that are administered with belantamab mafodotin, see section 5.1 and the respective current Summary of Product Characteristics.

Table 1. Recommended starting dose schedule for belantamab mafodotin in combination with other therapies:

Combination regimenRecommended starting dose schedule
With pomalidomide and dexamethasone (BPd)
(Cycle length = 4 weeks)
Cycle 1: 2.5 mg/kg administered once
Cycle 2 onwards: 1.9 mg/kg administered once
every 4 weeks

If a planned dose of belantamab mafodotin is missed due to reasons other than adverse reactions, it is recommended that belantamab mafodotin be resumed with the start of the next planned treatment cycle.

If a planned dose of belantamab mafodotin is missed due to adverse reactions, it is recommended that belantamab mafodotin be resumed with the start of the next planned treatment cycle after recovery of adverse reactions.

Dose modifications

Dose modifications are required for nearly all patients to manage safety and tolerability. Dose reduction levels for belantamab mafodotin are provided in Table 2.

Table 2. Dose reduction schedule for belantamab mafodotin:

 Combination with pomalidomide and
dexamethasone
Recommended starting
dose schedule
2.5 mg/kg once on cycle 1 then
1.9 mg/kg every 4 weeks starting on
cycle 2
Reduced dose level 11.9 mg/kg every 8 weeks
Reduced dose level 21.4 mg/kg every 8 weeks

Body weight

Belantamab mafodotin is dosed based on baseline actual body weight and has been studied in patients with body weight 37 to 170 kg. For changes of body weight >10% during treatment, re-calculate dose based on the actual body weight at the time of dosing.

Active ingredient

Belantamab mafodotin

Belantamab mafodotin is a humanised IgG1κ monoclonal antibody conjugated with a cytotoxic agent, maleimidocaproyl monomethyl auristatin F (mcMMAF). Belantamab mafodotin binds to cell surface BCMA and is rapidly internalised. Apoptosis induced by belantamab mafodotin is accompanied by markers of immunogenic cell death, which may contribute to an adaptive immune response to tumour cells.

Read more about Belantamab mafodotin

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