(332) Burden of Administration: Belantamab Mafodotin (Belamaf) Combinations vs Isatuximab (Isa) + Carfilzomib (K) + Dexamethasone (d), Daratumumab (D) + K + d, and K + d in Relapsed/Refractory Multiple Myeloma (RRMM)

Background: : Belamaf is being investigated after first relapse or later in phase 3 RRMM studies: DREAMM-7 (NCT04246047; belamaf with bortezomib and dexamethasone [BVd]) and DREAMM-8 (NCT04484623; belamaf with pomalidomide and dexamethasone [BPd] in lenalidomide-exposed patients [pts]). The regimens demonstrated significant progression-free survival (both BVd/BPd) and overall survival (BVd) benefits, and 88% (DREAMM-7)/90% (DREAMM-8) of pts had extended dosing intervals to manage ocular events, with administration (admin) burden reducing over the first year (Y).

Objective: : Admin burden in pts on treatment was evaluated for BVd/BPd vs intravenously (IV) administered second-line-or-later standards of care, IsaKd/DKd/Kd.

Methods: : A model estimating admin burden per pt receiving BVd/BPd/IsaKd/DKd/Kd for the first 2 years of treatment was developed. Dosing regimens were obtained using weekly individual pt-level dosing data from DREAMM-7/DREAMM-8 (BVd/BPd), and from published protocols (IsaKd/DKd/Kd). Admin burden inputs (admin number, clinic visits, and admin/monitoring [including ocular exam for BVd/BPd] durations) for the IV and subcutaneous (SC) agents were sourced from published protocols/clinician input. Oral agents were assumed to not require admin visits. Admin/monitoring costs were determined using the CMS Physician Fee Schedule 2025/Physician’s Fee and Coding Guide. Reported results are means per pt on treatment.

Results: : For BVd, 9.1/9.7 IV belamaf/SC bortezomib admins and 10.7 admin/monitoring hours (hrs) were required in Y1, with 6.6/0.0 admins and 6.6 hrs in Y2, totaling $972/$1,126 for admin/monitoring across Y1–Y2. For BPd, 6.2 IV belamaf admins and 6.2 admin/monitoring hrs were required in Y1, with 3.3 admins and 3.3 hrs in Y2, totaling $551/$686 for admin/monitoring across Y1–Y2. For IsaKd, 28.0/78.0 IV isatuximab/carfilzomib admins and 80.3 admin/monitoring hrs were required in Y1, with 26.0/78.0 admins and 78.0 hrs in Y2, totaling $12,197/$2,170 for admin/monitoring across Y1–Y2. For DKd, 24.0/78.0 SC daratumumab/IV carfilzomib admins and 70.3 admin/monitoring hrs were required in Y1, with 13.0/78.0 admins and 67.2 hrs in Y2, totaling $9,586/$2,170 for admin/monitoring across Y1–Y2. Kd required 78.0 IV carfilzomib admins in each year, with 66.3 (Y1) and 65.0 (Y2) admin/monitoring hrs, totaling $9,071/$2,170 for admin/monitoring across Y1–Y2. Sensitivity analyses were consistent with primary analyses. Alternative admin times were explored.

Conclusions: : BVd/BPd are associated with substantially lower admin burden/costs vs IsaKd/DKd/Kd.

Sponsorship:: GSK