DREAMM-7 Trial: BVd Superior to DVd in Patients With MM With High-Risk Cytogenetic Features

Treatment with belantamab mafodotin, bortezomib, and dexamethasone (BVd) exhibited a significant survival benefit compared with daratumumab, bortezomib, and dexamethasone (DVd) for patients with relapsed or refractory multiple myeloma (MM) with high-risk cytogenetic abnormalities (HRCAs), according to the DREAMM-7 trial.

The results were presented by Maria-Victoria Mateos, MD, PhD, of the Hospital Universitario de Salamanca in Spain, at the 2025 American Society of Clinical Oncology Annual Meeting,  May 30-June 3, 2025, in Chicago, Illinois.

A total of 494 patients were randomized 1:1 to receive either BVd (n=243) or DVd (n=251). One hundred and twenty-two (50%) patients in the BVd group and 115 (46%) patients in the DVd group had HRCAs, including t(4;14), t(14;16), t(14;20), 17p13del, and amp1q. Progression-free survival (PFS), overall survival (OS), and overall response rates were reported for patients with at least one HRCA.

The median PFS was 33.2 months (95% CI, 20.1-not reached) with BVd and 11.1 months (95% CI, 9.0-15.1) with DVd (hazard ratio, 0.40; 95% CI, 0.27-0.59), and the 18-month PFS rates were 61% for BVd and 38% for DVd. BVd also demonstrated a superior PFS across subgroups.

BVd also showed a significant benefit in terms of OS, with a median OS of not reached compared with 42.9 months for DVd. For patients with amp1q, the median OS was not reached with BVd and 34.3 months with DVd.

Ninety-nine patients (81%; 95% CI, 73.1%-87.7%) in the BVd group achieved an overall response compared with 79 patients (69%; CI, 59.4%-77.0%) in the DVd group, a pattern replicated across subgroups. In addition, a larger number of patients in the BVd group achieved a complete response or better compared with patients in the DVd group.

“Current outcomes in patients with high-risk cytogenetic features are suboptimal, and these results support BVd as a potential standard-of-care regimen in a patient population with high unmet need,” Dr. Mateos concluded during her presentation.