An evaluation of elranatamab for the treatment of myeloma: current evidence for treating relapsed/refractory disease and future directions.

Abstract

The development of B-cell maturation antigen (BCMA)-directed therapies has been a significant advancement for the treatment of multiple myeloma. Elranatamab is a bispecific antibody (BsAb) targeting BCMA and CD3. It has achieved regulatory approval in several jurisdictions worldwide for the treatment of patients with relapsed/refractory multiple myeloma. Clinical trials of elranatamab in various settings are currently ongoing.

This article describes the current evidence for treating relapsed/refractory multiple myeloma with elranatamab. A search for relevant literature was conducted in PubMed, EMBASE, Cochrane Library, and hematology conference abstracts published between 2017 and 2025. Citation mining of the included studies was also conducted.

Elranatamab monotherapy has demonstrated manageable safety and encouraging efficacy in relapsed/refractory multiple myeloma. The overall toxicity profile is comparable to other BCMA-targeting BsAbs. The low grade of cytokine release syndrome (CRS) supports the administration of elranatamab in the outpatient setting. High infection rates remain a challenge, although further refinement of anti-infection prophylaxis and adjustment of the dosing schedule may reduce the risk. Clinical trials are currently investigating elranatamab in different settings to further enhance the efficacy, including as a first-line treatment and combination regimens, although benefits need to be weighed against the increased toxicity risk.