Kidney Week

Abstract: SA-PO1240

Safety and Efficacy of Belantamab Mafodotin in Patients with Relapsed/Refractory Multiple Myeloma and Kidney Impairment: An Analysis of the ALGONQUIN Trial

Session Information

• Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1600 Onconephrology

Authors

• Almalki, Lamis A., Prince Sultan Military Medical City, Riyadh, Riyadh Province, Saudi Arabia

Lamis A. Almalki, MD, MBBS

• Kitchlu, Abhijat, University Health Network, Toronto, Ontario, Canada

Abhijat Kitchlu, MD, MS, MSc

• Trudel, Suzanne, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada

Suzanne Trudel, MD

• Su, Jiandong, University Health Network, Toronto, Ontario, Canada

Jiandong Su, MSc

• Vohra, Harjot Singh, University Health Network, Toronto, Ontario, Canada

Harjot Singh Vohra, MD, MSc

Background

Renal impairment is common in relapsed refractory multiple myeloma (RRMM) and is associated with inferior outcomes. Data on the renal safety and efficacy of belantamab mafodotin (belamaf) in patients with renal impairment (RI) remain limited. We analyzed data from the ALGONQUIN trial, a prospective multicenter study evaluating the safety and efficacy of belamaf in combination with pomalidomide in RRMM.

Methods

Patients were categorized by baseline estimated glomerular filtration rate (eGFR, mL/min/1.73m²) as: normal (≥90), mildly impaired (60–89), or moderately impaired (30–59). We assess renal, survival, and safety outcomes using Cox models and Kaplan-Meier analysis. Primary outcomes included acute kidney injury (AKI) and major adverse kidney events (MAKE). Secondary outcomes included IMWG-defined renal response, overall response rate (ORR), overall survival (OS), and safety endpoints.

Results

Among 120 included patients, 42% had normal baseline renal function, 42% had mildly impaired, and 17% had moderately impaired renal function. AKI occurred in 29% patients, with similar incidence across renal function groups: adjusted hazard ratio (aHR) 1.83 (95% CI: 0.76–4.40) for mild impairment, and aHR 1.51 (95% CI: 0.38–6.03) for moderate impairment, versus normal function. MAKE occurred in 48%, though risk was not associated with baseline renal impairment (mildly impaired: aHR 1.19, 95% CI: 0.61–2.32, moderately impaired: aHR 1.46, 95% CI: 0.55–3.88). Among 31 evaluable patients with baseline RI, 42% achieved complete renal response, predominantly in the moderately impaired group (p=0.03). ORR was higher in patients with normal renal function compared with patients with moderate renal impairment(p = 0.042). OS did not significantly differ by baseline renal function (log-rank p = 0.6119), with a median OS of 44 months (95% CI: 30–NE) for mildly impaired patients, 39 months (22–NE) for moderately impaired patients, and not reached (NE) for patients with normal renal function. Adverse events were comparable across groups.

Conclusion

Overall, Belamaf in combination with pomalidomide and dexamethasone demonstrated similar renal, survival and safety outcomes in patients with mild to moderate RI, with a substantial proportion achieving renal response. Patients with RI should not be precluded from belamaf-based therapy.