GSK’s Blenrep was the first BCMA-directed agent to reach the market, but this is not what the drug will be remembered for – the failure of a crucial confirmatory trial means the antibody-drug conjugate could be pulled from the market. Blenrep has always sat among the least impressive of the anti-BCMA pack, a weakness that has now been laid bare in the disastrous Dreamm-3 readout. The third-line multiple myeloma trial pitted Blenrep against Bristol Myers Squibb’s Pomalyst; success could have converted Blenrep’s fourth-line accelerated approval into a full green light. But the primary endpoint was a clear bust, and while response rates might have trended in Blenrep’s favour the admittedly immature overall survival result is also pointing the wrong way.
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