Management of Belantamab Mafodotin–Associated Keratopathy With Rigid Gas-Permeable Corneal Contact Lenses

Abstract

Belantamab mafodotin is a relatively new drug used in the treatment of relapsed or refractory multiple myeloma. Clinical studies have shown promising responses, but ocular toxicity remains a major challenge with dose reduction or therapy discontinuation being the only available treatment option. We report a clinical case of a patient with severe keratopathy under therapy with belantamab. The use of rigid gas-permeable corneal contact lenses led to a major visual improvement and enabled therapy continuation at full dose over several months. Although this strategy may not be suitable for all patients, it provides an additional option for the treatment of ocular toxicity of this promising agent.

Soluble B-cell maturation antigen in lacrimal fluid as a potential biomarker and mediator of keratopathy in multiple myeloma

“…The DREAMM-1 and DREAMM-2 trial protocols investigated several mitigation strategies to reduce belantamab-induced keratopathy 14,16 . The use of cooling eye masks, vasoconstrictors or corticosteroids have been disappointing in regard to keratopathy-protective effects 42 , whereas the use of rigid gas-permeable corneal contact lenses can lead to major visual improvement to enable therapy continuation 43 . Current strategies concentrate on dose reductions and extended treatment-free intervals, along with the use of preservative-free artificial tears.…”