Elranatamab
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-ELRANATAMAB |
|---|---|
| Type | Drug |
| Aliases | ElrexfioЕлранатамаб |
| Status | reviewed 2026-04-29 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-ESMO-MM-2023 SRC-NCCN-MM-2025 |
Drug Facts
| Class | BCMA × CD3 bispecific T-cell engager (humanized IgG2a) |
|---|---|
| Mechanism | Humanized bispecific antibody binding BCMA (B-cell maturation antigen, expressed on plasma cells + myeloma) on one arm and CD3 on cytotoxic T-cells on the other. Forms immune synapse → T-cell activation, cytokine release + targeted plasma-cell killing independent of TCR specificity. Step-up dosing schedule mitigates first-cycle CRS. Off-the-shelf alternative to BCMA CAR-T for triple-class refractory MM (no manufacturing window). |
| Typical dosing | Step-up dosing required (CRS mitigation): 12 mg SC day 1, 32 mg SC day 4 — minimum 48-72h between doses, with hospitalization for observation. Full dose: 76 mg SC weekly through week 24, then every 2 weeks thereafter (response-adapted; reduces infection burden and improves convenience). Continue until progression or unacceptable toxicity. |
| Ukraine registered | False |
| NSZU reimbursed | False |
| Ukraine last verified | 2026-04-29 |
Warnings
- Cytokine release syndrome (CRS) — ~58% any grade, ~0% Grade ≥3 in MagnetisMM-3
- Neurologic toxicity / ICANS (~3% Grade ≥3)
- Serious infections — Grade ≥3 ~40%; opportunistic + bacterial; hypogammaglobulinemia universal
- Hepatotoxicity
Notes
MagnetisMM-3 (Lesokhin 2023, Nat Med): triple-class refractory MM after ≥4 prior lines (median 5) — ORR 61%, CR ~35%, mPFS ~17 mo in BCMA-naive cohort. FDA accelerated approval Aug 2023; EMA Dec 2023. Hospitalization REQUIRED for step-up doses (CRS observation 48-72h after each). Tocilizumab + corticosteroids for CRS management. Mandatory PJP + HSV prophylaxis; IVIG supplementation for IgG <400 (universal hypogammaglobulinemia). Bi-weekly dosing after week 24 reduces infection burden vs continuous weekly schedules. NOTE: Pivotal trial Source SRC-MAGNETISMM-3-LESOKHIN-2023 not yet in KB — evidence base cited via NCCN-MM and ESMO-MM guideline references; flag for source-stub creation.
Used By
Regimens
REGIMEN-ELRANATAMAB-MONO-MM- Elranatamab BCMA × CD3 bispecific monotherapy — SC weekly then q2-weekly (MagnetisMM-3)REGIMEN-ELRANATAMAB-STEP-UP-DOSING-MM- Elranatamab BCMA × CD3 bispecific — inpatient step-up dosing schedule