Overview
Belantamab mafodotin (belamaf) is an antibody-drug conjugate used to treat relapsed or refractory multiple myeloma 1. Ocular adverse events are a common side effect of this therapy, primarily manifesting as changes to the corneal epithelium 1. These events are generally reversible and can be managed through treatment schedule adjustments 1.Diagnosis
Baseline Evaluation: All patients should undergo a comprehensive ophthalmic examination by an eye specialist before initiating therapy 1.
Grading System: Ocular toxicity is identified and monitored using the Keratopathy and Visual Acuity (KVA) scale 1.
Severity: The majority of belamaf-associated ocular events are classified as Grade 1 or 2 per the KVA scale 1.Management
Dose Modification: The primary management strategy involves delaying doses or decreasing the frequency of administration 1.
Supportive Care: Use of artificial tears is recommended to manage corneal epithelial changes 1.
Reversibility: Ocular events are reversible in almost all patients with appropriate monitoring and dose adjustments 1.Special Populations
Rapid Disease Progression: If a patient is progressing rapidly or if there are significant delays in obtaining a specialist eye exam, initiation of therapy may be considered based on clinical urgency 1.Key Recommendations
Perform a baseline ophthalmic evaluation with an eye specialist for all patients prior to starting belantamab mafodotin 1. (Evidence: Strong)
Manage ocular adverse events primarily through dose delays and/or reduced frequency of dosing 1. (Evidence: Strong)
Utilize artificial tears as a standard adjunctive measure to minimize the impact of corneal epithelial changes 1. (Evidence: Moderate)
Monitor and grade ocular toxicity using the Keratopathy and Visual Acuity (KVA) scale to guide treatment modifications 1. (Evidence: Strong)References
1 Terpos E, Trudel S, Mateos MV, Alejandre N, Colby K, Dimopoulos MA et al.. Practical Guidance on Clinical Management of Belantamab Mafodotin-Associated Ocular Events. American journal of hematology 2025. link