Best-corrected visual acuity (BCVA) changes and ocular symptoms may affect the management of belantamab mafodotin (belamaf) dosing among patients with relapsed or refractory multiple myeloma (RRMM), according to research presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.
Investigators conducted a post hoc investigation from the DREAMM-2 trial (ClinicalTrials.gov Identifier: NCT03525678) to determine whether BCVA changes and ocular symptoms could help guide dosing in place of corneal examinations.
Ophthalmologists conducted eye evaluations, which included a corneal examination and BCVA assessment of Snellen visual acuity, in 773 patients who received belamaf (2.5 mg/kg) at baseline and before each dose. Corneal epithelium (Ker) and BCVA changes were assessed according to protocol-defined criteria, and grade assessment was based on the worse eye. BCVA grading was relative to baseline, and patient-reported ocular symptoms were reported with use of the Common Terminology Criteria for Adverse Events.
The study authors found that in 12.5% of eye evaluations, grade 3 to 4 Ker were associated with minimal or no (grade ≤1) BCVA changes. When the researchers included patient-reported ocular symptoms, 7.5% of the examinations found grade 3 to 4 Ker with grade 1 or better BCVA changes or ocular symptoms. Having mild or no (grade ≤2) Ker was associated with grade 1 or better BCVA changes in 59.5% of evaluations, or in 38.8% of evaluations with no ocular symptoms. Grade 3 to 4 Ker was found in 24.9% of overall evaluations, and grade 2 to 4 BCVA changes or ocular symptoms were found in 53.7% of evaluations.
“These findings highlight that BCVA changes and ocular symptoms should be further investigated to determine if they can be used as alternatives (eg, frequency of eye examinations based on symptoms) for the management of belamaf dosing to potentially reduce the burden on patients and healthcare professionals,” the investigators concluded.
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Reference
Terpos E, Badros A, Popat R, et al. Relationship between corneal exam findings, best-corrected visual acuity (BCVA), and ocular symptoms in patients with relapsed or refractory multiple myeloma (RRMM) receiving belantamab mafodotin (belamaf). J Clin Oncol. 2021;39:(suppl 15; abstr 8033). doi:10.1200/JCO.2021.39.15_suppl.8033