Elranatamab
Elranatamab is Pfizer's BCMA bispecific, given under the skin every week then every two weeks, for myeloma after four prior lines.
MagnetisMM-3: ORR 61%, CR 35% in BCMA-naive patients; median PFS ~17 months. Accelerated approval August 2023. MagnetisMM-5 (with daratumumab, vs Dara-Pd) and MagnetisMM-7 (post-transplant maintenance) are the confirmatory phase 3s.
- Route
- Subcutaneous
- Schedule
- 12 mg day 1, 32 mg day 4, 76 mg weekly from day 8; every 2 weeks after 24 weeks if responding
- Monitoring
- CRS/ICANS (48-hour hospitalisation after first two step-up doses), infections, IVIG for hypogammaglobulinaemia
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Step-up dosing is often started in hospital (Part A) because of cytokine release syndrome monitoring, then continued in the outpatient setting.
- Commercial insurance
- covered with prior authorisation
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
- Assistance programmes
- Pfizer Oncology Together
- Pfizer RxPathways
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
- Leukemia & Lymphoma Society financial support
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Notes
- Licensed 2024; NICE recommended it via the Cancer Drugs Fund in 2024. TA number not verified.
Sources: NICE search: elranatamab. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2023 | Relapsed/refractory myeloma after ≥4 lines (accelerated) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Cytokine release syndrome | 58% | 0% |
| Infections | 70% | 40% |
| Neutropenia | — | 49% |
MagnetisMM-3 cohort A. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
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.
Teclistamab showed that an off-the-shelf bispecific can approach CAR-T-like response rates in late myeloma, giving patients who cannot wait for or access cell therapy a real option. It also exposed the price: prolonged T-cell engagement causes profound immunosuppression, so infection prophylaxis and immunoglobulin replacement are now routine. Less frequent dosing after response is being adopted to reduce this burden.
Latest papers
topQuery for this drug: (TITLE:"Elranatamab" OR ABSTRACT:"Elranatamab" OR TITLE:"Elrexfio" OR ABSTRACT:"Elrexfio") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Elranatamab, not a curated reading list.
Pages like this
not linked directly; found by shared links- ProductLinvoseltamab
Shares Caution: T-cell redirectors and infections, BCMA, CD3, T-cell engagers (bispecific).
- ProductTalquetamab
Shares MagnetisMM-3: elranatamab, a second BCMA bispecific, with a switch to fortnightly dosing after response, MajesTEC-1: teclistamab, an off-the-shelf BCMA bispecific antibody, in heavily pretreated myeloma, CD3, T-cell engagers (bispecific).
- ProductTeclistamab
Shares Caution: T-cell redirectors and infections, MagnetisMM-3: elranatamab, a second BCMA bispecific, with a switch to fortnightly dosing after response, MajesTEC-1: teclistamab, an off-the-shelf BCMA bispecific antibody, in heavily pretreated myeloma, BCMA.
- ProductPasritamig
Shares CD3, Cytokine release syndrome (CRS), T-cell engagers (bispecific).
- PairingBCMA-directed therapy → GPRC5D-directed therapy
Shares MajesTEC-1: teclistamab, an off-the-shelf BCMA bispecific antibody, in heavily pretreated myeloma, BCMA, Multiple myeloma.
- InstitutionComprehensive Cancer Center Mainfranken, University Hospital Würzburg
Shares BCMA, Cytokine release syndrome (CRS), T-cell engagers (bispecific), Multiple myeloma.
- TrialLINKER-MM1
Shares MagnetisMM-3: elranatamab, a second BCMA bispecific, with a switch to fortnightly dosing after response, Multiple myeloma.
- ProductIdecabtagene vicleucel
Shares BCMA, Cytokine release syndrome (CRS), Multiple myeloma.