Bela-Vd vs. Tec-Dara for RRMM: an indirect comparison

A poster at the European Hematology Association (EHA) 2026 Congress reported on an indirect comparison of two BCMA-targeted regimens for patients with relapsed/refractory multiple myeloma (RRMM): belantamab mafodotin plus bortezomib and dexamethasone (Bela-Vd) and teclistamab plus daratumumab (Tec-Dara). Both regimens have recently demonstrated clinical benefit in phase III studies involving patients previously exposed to one to three prior lines of therapy.

Bela-Vd had previously shown improvements in progression-free survival (PFS) and overall survival (OS) compared with Vd alone. Similarly, the MajesTEC-3 study demonstrated superior PFS for Tec-Dara versus standard-of-care regimens, including daratumumab, pomalidomide and dexamethasone or daratumumab, bortezomib and dexamethasone.

The indirect comparison revealed no significant difference in OS between Bela-Vd and Tec-Dara. However, notable differences in safety outcomes were observed, with Tec-Dara being linked to increased rates of infections and cytokine release syndrome relative to Bela-Vd.

For Prof Vekemans (Cliniques Universitaires Saint-Luc, Brussels, Belgium), these findings highlight the importance of careful patient selection when implementing BCMA-targeted therapies. For example, Tec-Dara may be less appropriate for patients with a history of recurrent infections, while Bela-Vd may be a more suitable option for patients with significant comorbidities or a higher susceptibility to infectious complications.