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**Belantamab mafodotin + bortezomib + dexamethasone** is a fixed-drug combination used in the treatment of relapsed or refractory multiple myeloma. - Belantamab mafodotin is an antibody-drug conjugate (ADC) targeting B-cell maturation antigen (BCMA), a surface protein highly expressed on malignant plasma cells. The ADC consists of a fully humanized IgG1 anti-BCMA monoclonal antibody conjugated via a non-cleavable linker to monomethyl auristatin F (MMAF), a microtubule inhibitor. This leads to targeted cytotoxicity, antibody-dependent cellular cytotoxicity (ADCC), antibody-dependent cellular phagocytosis (ADCP), and induction of immunogenic cell death in BCMA-expressing cells. - Bortezomib is a proteasome inhibitor that disrupts protein degradation, leading to apoptosis in rapidly dividing myeloma cells. - Dexamethasone is a synthetic glucocorticoid with anti-inflammatory and cytotoxic effects on plasma cells. The combination (commonly abbreviated as BVd) is administered intravenously and was evaluated as first-line combination in relapsed/refractory multiple myeloma in Phase 3 trials (notably DREAMM-7), where it significantly improved progression-free survival and overall survival compared to standard regimens containing daratumumab[1][2][5][7].
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