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Elranatamab produced responses in 61% of heavily pretreated myeloma patients and showed that dosing can be thinned to every two weeks once patients respond.
MagnetisMM-3 was a phase 2 single-arm study of elranatamab, a subcutaneous BCMA x CD3 bispecific, in 123 patients with triple-class-exposed relapsed or refractory multiple myeloma who had not received prior BCMA-directed therapy (cohort A). After two step-up doses and weekly dosing, patients who had responded for at least six months moved to every-two-week dosing. The overall response rate was 61% with complete response or better in 35%; most responses were ongoing at a year. CRS occurred in about 58% of patients, all grade 1-2 with the priming regimen, and neurotoxicity in a small minority. Infections were the main serious toxicity. The FDA granted accelerated approval in 2023.
Elranatamab confirmed that BCMA bispecifics are a class, not a one-off, and its protocol-built dose reduction after response set a precedent for lowering the immunosuppressive burden of T-cell engagers. Patients now have two approved BCMA bispecifics and one against GPRC5D (talquetamab). Choosing between them, and sequencing them with CAR-T, remains guided by availability and toxicity profile rather than head-to-head data.
Shares GPRC5D, MajesTEC-1: teclistamab, an off-the-shelf BCMA bispecific antibody, in heavily pretreated myeloma, Talquetamab, Teclistamab.
Shares MajesTEC-1: teclistamab, an off-the-shelf BCMA bispecific antibody, in heavily pretreated myeloma, Teclistamab, BCMA, CD3.
Shares GPRC5D, Teclistamab, BCMA, Cytokine release syndrome (CRS).
Shares Talquetamab, Teclistamab, BCMA, Bispecific antibodies.
Shares GPRC5D, CD3, Bispecific antibodies, T-cell engagers (bispecific).
Shares LINKER-MM1, Caution: T-cell redirectors and infections, BCMA, CD3.
Shares Talquetamab, Teclistamab, T-cell engagers (bispecific), Multiple myeloma.
Shares Elranatamab, Teclistamab, Cytokine release syndrome (CRS), Bispecific antibodies.