DREAMM-7 study – subgroup analysis in lenalidomide-refractory patients

The DREAMM-7 study was a phase III trial comparing belantamab mafodotin plus bortezomib and dexamethasone (BVd) to daratumumab with bortezomib and dexamethasone (DVd) in relapsed or refractory multiple myeloma (RRMM). In this trial, BVd significantly improved the progression-free survival compared to DVd and induced a strong overall survival benefit.

During IMS 2025, Prof Dr Vania Hungria, haematologist at the Clinica São Germano in São Paolo (Brazil) presented the results of a subgroup analysis of this trial, focussing on lenalidomide-refractory patients. The results in this subgroup were in line with the overall DREAMM-7 results, with a median PFS of 35.7 months for BVd-treated patients as compared to 13.5 months with DVd (HR[95%CI]: 0.39[0.17-0.88]). In addition, BVd was associated a higher rate of deep responses and a significantly longer duration of response compared to DVd.

For Prof Hungria, these findings are particularly relevant given the increasing number of patients who are being exposed to lenalidomide in frontline treatment. As CAR-T therapies are not universally accessible or feasible, the use of anti-BCMA antibodies like belantamab mafodotin offer a valuable new therapeutic option. Therefore, these data strongly support the incorporation of this agent as a standard treatment for MM patients at first relapse. This includes patients who are lenalidomide-refractory, addressing a critical gap in care for this growing patient population.