Building on the success of monoclonal antibodies, conjugates have been developed that use the same or similar targets but use these to specifically traffic other drugs directly to the myeloma cell. One example is to combine a chemotherapy drug with a monoclonal antibody. An advantage of these conjugates is the ability to use stronger and otherwise more toxic chemotherapy agents. Belantamab mafodotin for example acts to direct the chemotherapy mafdotin to myeloma cells by binding to the protein BCMA which is expressed at high levels on their surface. Belantamab mafodotin is available in Europe but not currently through the NHS in the UK. It can be accessed by some patients through clinical trials, and more recently is being investigated in combination with other drugs in the DREAMM clinical trial programme.
Generally belantamab mafodotin is relatively well tolerated. However one serious side effect of patients treated with belantamab mafodotin is keratopathy (changes to the cornea), leading to blurred vision and dry eyes. Patients should be given eye drops and have regular eye check-ups. Other side effects include nausea, anaemia, and reduced platelets in the blood.