Elranatamab

How it works

It binds B-cell maturation antigen (BCMA) on myeloma cells and CD3 on T cells, bringing them together to trigger T-cell-mediated killing of the malignant plasma cells.

Prescribing in practice

• Can cause cytokine release syndrome and neurological toxicity including immune effector cell-associated neurotoxicity, so step-up dosing and monitoring in an appropriately equipped setting are required.
• It increases the risk of serious infections, so infection prophylaxis and prompt treatment of infections are important.
• Treatment should be initiated and supervised by clinicians experienced in managing myeloma and the toxicities of T-cell engaging therapies.

Monitoring

Monitor closely for cytokine release syndrome, neurological symptoms, infections and blood counts during and after dosing.

Counselling the patient

• Report fever, breathlessness, confusion or any new neurological symptoms to your team straight away.
• Tell your team about any signs of infection promptly, as these can become serious.

Evidence & guidelines

Bispecific BCMA-directed antibodies are used in relapsed or refractory multiple myeloma in line with their licensed indications and NICE appraisals.