Abstract
Purpose :
To characterize the ocular outcomes for patients taking belantamab mafodotin (belamaf) and determine what factors lead to dosage modifications.
Methods :
We conducted a retrospective review of patients with multiple myeloma who were treated with belamaf at the University of Chicago Medical Center (Chicago, IL). We collected baseline demographic information and reviewed the best corrected visual acuity (BCVA), intraocular pressure (IOP), and corneal exam findings at baseline and at any visit where ocular toxicity grade had worsened. We assessed what clinical characteristics lead to a dose delay, dose reduction, or dose termination.
Results :
Among patients receiving treatment with belamaf for multiple myeloma, the average age was 69.7 years and 44% were women. 45% were non-Hispanic Caucasian and 55% were African American. 66.7% of patients developed micro-cyst-like epithelial changes (MEC) after 2 rounds of treatment. Patients were noted to have worsening vision between rounds 2 and 4, which corresponded to worsening MEC and keratopathy. Overall patients underwent 4.2 rounds of treatment before discontinuing treatment or expiring. Ocular toxicity, which is based on slit lamp findings and Snellen visual acuity, at each dose change ranged from 1-3. Patients who required a dose change decreased their dose from 2.5 to 1.9 mg/kg. 33% of all patients required a dose change, and of this subgroup 33% was for thrombocytopenia and 67% for ocular toxicity due to MEC. These patients had an average of 3.67 rounds of treatment before needing a dose change. Of the 44% patients who ultimately terminated treatment, only 1 was due to ocular toxicity.
Conclusions :
Patient’s receiving belamaf require frequent monitoring for ocular toxicity. Our results suggest that patients may be able to tolerate the ocular toxicities related to belamaf with careful monitoring from ophthalmologists and dose delay or dose reductions as needed. Further analysis and studies are needed to characterize what specific ocular and non-ocular features lead to dosage modifications.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.