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dc.contributor.authorFarooq, Asim V.
dc.contributor.authorDegli Esposti, Simona
dc.contributor.authorPopat, Rakesh
dc.contributor.authorThulasi, Praneetha
dc.contributor.authorLonial, Sagar
dc.contributor.authorNooka, Ajay K.
dc.contributor.authorJakubowiak, Andrzej
dc.contributor.authorSborov, Douglas
dc.contributor.authorZaugg, Brian E.
dc.contributor.authorBadros, Ashraf Z.
dc.contributor.authorJeng, Bennie H.
dc.contributor.authorCallander, Natalie S.
dc.contributor.authorOpalinska, Joanna
dc.contributor.authorBaron, January
dc.contributor.authorPiontek, Trisha
dc.contributor.authorByrne, Julie
dc.contributor.authorGupta, Ira
dc.contributor.authorColby, Kathryn
dc.descriptionSee also: Corrections at
dc.description.abstractIntroduction: Patients with relapsed or refractory multiple myeloma (RRMM) represent an unmet clinical need. Belantamab mafodotin (belamaf; GSK2857916) is a first-in-class antibody–drug conjugate (ADC; or immunoconjugate) that delivers a cytotoxic payload, monomethyl auristatin F (MMAF), to myeloma cells. In the phase II DREAMM-2 study (NCT03525678), single-agent belamaf (2.5 mg/kg) demonstrated clinically meaningful anti-myeloma activity (overall response rate 32%) in patients with heavily pretreated disease. Microcyst-like epithelial changes (MECs) were common, consistent with reports from other MMAF-containing ADCs. Methods: Corneal examination findings from patients in DREAMM-2 were reviewed, and the clinical descriptions and accompanying images (slit lamp microscopy and in vivo confocal microscopy [IVCM]) of representative events were selected. A literature review on corneal events reported with other ADCs was performed. Results: In most patients receiving single-agent belamaf (72%; 68/95), MECs were observed by slit lamp microscopy early in treatment (69% had their first event by dose 4). However, IVCM revealed hyperreflective material. Blurred vision (25%) and dry eye (15%) were commonly reported symptoms. Management of MECs included dose delays (47%)/reductions (25%), with few patients discontinuing due to MECs (1%). The first event resolved in most patients (grade ≥2 MECs and visual acuity[each 77%], blurred vision [67%], and dry eye [86%]), with no reports of permanent vision loss to date. A literature review confirmed that similar MECs were reported with other ADCs; however, event management strategies varied. The pathophysiology of MECs is unclear, though the ADC cytotoxic payload may contribute to on- or off-target effects on corneal epithelial cells. Conclusion: Single-agent belamaf represents a new treatment option for patients with RRMM. As with other ADCs, MECs were observed and additional research is warranted to determine their pathophysiology. A multidisciplinary approach, involving close collaboration between eye care professionals and hematologist/oncologists, is needed to determine appropriate diagnosis and management of these patients. Trial Registration: Identifier, NCT03525678. © 2020, The Author(s).en_US
dc.publisherSpringer Science and Business Media LLCen_US
dc.relation.ispartofOphthalmology and Therapyen_US
dc.subjectAntibody–drug conjugateen_US
dc.subjectBelantamab mafodotinen_US
dc.subjectIn vivo confocal microscopyen_US
dc.subjectMicrocyst-like epithelial changesen_US
dc.subjectMonomethyl auristatin Fen_US
dc.subjectMultiple myelomaen_US
dc.titleCorneal Epithelial Findings in Patients with Multiple Myeloma Treated with Antibody–Drug Conjugate Belantamab Mafodotin in the Pivotal, Randomized, DREAMM-2 Studyen_US

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