OnCo
drugsProductApproved2020🇪🇺🇬🇧🇯🇵🇨🇳

Belantamab mafodotin

A myeloma ADC that was withdrawn in 2022 then came back in 2025 after strong trials in earlier lines.

DREAMM-7 (with bortezomib/dexamethasone) and DREAMM-8 (with pomalidomide/dexamethasone) showed PFS and OS benefits; re-approved in 2025 in the US and EU in second-line myeloma. Ocular toxicity (keratopathy) requires an ophthalmology-based REMS.

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Payload: MMAF · 2D coordinates (no PubChem conformer)
PubChem
How it works, step by step · animated schematic, not to scale
Antibody-drug conjugate (ADC)
Mechanism, step by step
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1.Antibody binds BCMA on the tumour cell surface

Modality
ADC
Mechanism
Afucosylated anti-BCMA IgG1 with MMAF; ADCC plus payload.
Brand / code
Blenrep
Payload
MMAF (tubulin inhibitor, non-permeable)
Linker
mc, non-cleavable
Dosing & schedule
Route
IV infusion
Schedule
2.5 mg/kg every 3 weeks with bortezomib/dexamethasone (DREAMM-7) or 2.5 mg/kg then 1.9 mg/kg every 4 weeks with pomalidomide/dexamethasone (DREAMM-8)
Dose modifications
Hold and reduce for keratopathy or visual acuity decline per REMS
Monitoring
Ophthalmic exam before each dose; preservative-free lubricants

Source: www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications. Doses are for orientation; the current label governs.

Medicare
Part B (clinician-administered)

Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Withdrawn from the US market in 2022–2023 and re-approved in 2025 in combination; ocular monitoring under a REMS.

Commercial insurance
covered with prior authorisation

Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments. Plans require documented prior lines and enrolment in the ocular REMS.

20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.

Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.

NICE recommendedSearch NICE
Appraised for
With bortezomib and dexamethasone for relapsed or refractory multiple myeloma after 1 or more treatments (DREAMM-7)
Notes
The UK was the first country to re-license belantamab (MHRA, April 2025) and NICE recommended it in 2025. TA number not verified; follow the NICE search link.
NHS England
Routinely funded for the appraised indication (or via managed access)

Sources: NICE search: belantamab mafodotin. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.

Regulatory

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  1. 5 Aug 2020ApprovalUS

    Accelerated approval, relapsed/refractory myeloma after ≥4 lines (DREAMM-2) source

  2. 22 Nov 2022WithdrawalUS

    Withdrawn after DREAMM-3 failed to confirm benefit source

  3. 23 Jul 2025Complete response letterUS

    Complete response letter on combination filing; resubmitted source

  4. Oct 2025ApprovalUS

    Approval in combination regimens for relapsed/refractory myeloma after ≥1 line (DREAMM-7/8) source

Approvals

RegionYearIndication
US2020Relapsed myeloma ≥4 lines (accelerated; withdrawn 2022)
US2025Relapsed/refractory myeloma after ≥1 prior line, in combination

Safety

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Toxicity profile
Adverse event
Keratopathy
Thrombocytopenia
Blurred vision
Dry eye
Infections

Ocular events in most patients; boxed warning. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.

Cost & access

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Cost & access
CountryReimbursement
United StatesMedicare Part B (physician-administered); commercial plans per formulary
United KingdomNICE: recommended in combination regimens for relapsed myeloma (2025)

List prices are manufacturer or Medicare figures where publicly disclosed; net prices after rebates are usually lower. Reimbursement changes; check the payer.

Trials

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ClinicalTrials.gov · phase 2/3
refreshed 2026-09-09
57 studies15 recruiting47 Phase 210 Phase 3
Search “Belantamab mafodotin” on ClinicalTrials.gov →
Counts are from a name search and may include unrelated studies; up to 100 studies are summarised.

Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Belantamab mafodotin
intervention: Belantamab mafodotin
Open on ClinicalTrials.gov →

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Latest papers

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Literature trend49 papers in the last 12 months+9% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this drug: (TITLE:"Belantamab mafodotin" OR ABSTRACT:"Belantamab mafodotin" OR TITLE:"Blenrep" OR ABSTRACT:"Blenrep") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Belantamab mafodotin, not a curated reading list.

Connected

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