{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:52:26Z","timestamp":1783702346229,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Belantamab mafodotin (belamaf) is a BCMA-targeting antibody\u2013drug conjugate used in triple-class refractory multiple myeloma. Despite its efficacy, keratopathy remains a significant dose-limiting toxicity. Following its withdrawal from the U.S. market in 2022, its use in Austria is limited to clinical trials or compassionate use. Methods: In this real-world, retrospective study, we analyzed 36 relapsed\/refractory, BCMA-na\u00efve multiple myeloma patients treated at the University Hospital of Vienna (January 2020\u2013June 2024); 42% received a reduced dose (1.9 mg\/kg) throughout all treatment cycles. The primary objective was to assess adverse events, particularly keratopathy, and the impact of dose modifications on toxicity and efficacy. Results: The overall response rate was 64%, with responders having significantly fewer prior therapy lines (median 3 vs. 4.5, p = 0.015). Median PFS was 7.3 months, significantly longer in responders (11.1 vs. 1.6 months, p &lt; 0.0001); median OS was 20.1 months, also longer in responders (not reached vs. 18 months, p = 0.031). Keratopathy occurred in 75% of patients; 33% experienced grade 3\u20134 events. Dose reduction significantly decreased grade 3\u20134 keratopathy (7% vs. 52%, p = 0.004) and thrombocytopenia (33% vs. 67%, p = 0.048) without compromising efficacy. Conclusions: Belamaf dose reductions improved tolerability without loss of efficacy, supporting reduced dosing in practice.<\/jats:p>","DOI":"10.3390\/cancers17142398","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T07:56:14Z","timestamp":1753084574000},"page":"2398","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Optimizing Belantamab Mafodotin in Relapsed or Refractory Multiple Myeloma: Impact of Dose Modifications on Adverse Events and Hematologic Response in a Real-World Retrospective Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6008-029X","authenticated-orcid":false,"given":"Lina Zoe","family":"R\u00fcsing","sequence":"first","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Schweighofer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Aschauer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Jeryczynski","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Vospernik","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Gisslinger","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin Marcus","family":"Bumberger","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Cserna","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Riedl","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermine","family":"Agis","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Theresa","family":"Krauth","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1038\/leu.2013.313","article-title":"Continued improvement in survival in multiple myeloma: Changes in early mortality and outcomes in older patients","volume":"28","author":"Kumar","year":"2014","journal-title":"Leukemia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4464","DOI":"10.3390\/curroncol29070355","article-title":"Clinical Management of Triple-Class Refractory Multiple Myeloma: A Review of Current Strategies and Emerging Therapies","volume":"29","author":"Stalker","year":"2022","journal-title":"Curr. 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