Elranatamab

Elranatamab is a T-cell directing bispecific antibody targeting BCMA and CD3.

Evidence (elranatamab):

Summary: Patients with myeloma who have received one to four prior lines of therapy, are refractory to proteosome inhibitors and immunomodulatory agents, and are also experiencing a slow relapse are often referred for CAR T-cell therapy. This is because delays in production of the CAR T-cell agent are less problematic, and because time receiving therapy is fixed and short-term, allowing a long duration therapy-free time after a response.[49] Patients who experience a quick relapse may benefit from an "off-the-shelf" bispecific antibody that results in similar response rates and durability of response, but this approach comes with the downside of required continual therapy.[49] The choice of bispecific antibody cannot be made based on any clinical evidence because of the lack of comparative trials. In heavily pretreated patients, bispecific antibodies impair humoral immunity, but this can be ameliorated using IV or subcutaneous immunoglobulin and antimicrobial prophylaxis.[49] Current logic supports using products with different targets sequentially.