# Elranatamab

Source: https://onco.cc/drugs/elranatamab/  
OnCo record `elranatamab` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Elranatamab is Pfizer's BCMA bispecific, given under the skin every week then every two weeks, for myeloma after four prior lines.

## Summary

Elranatamab is a humanised IgG2a BCMAxCD3 bispecific antibody that links T cells to BCMA-expressing plasma cells, given subcutaneously with step-up doses of 12 mg and 32 mg, then 76 mg weekly and every 2 weeks after 24 weeks in responders. In MagnetisMM-3, BCMA-naive patients had ORR 61% and CR 35% with median PFS of about 17 months, leading to accelerated approval in August 2023 after at least 4 prior lines. Cytokine release syndrome was common but mild; infections affected 70% (40% grade 3 or higher), so IVIG for hypogammaglobulinaemia and infection vigilance are central to its use. MagnetisMM-5 (with daratumumab, versus Dara-Pd) and MagnetisMM-7 (post-transplant maintenance) are the confirmatory phase 3 trials. Pfizer develops it. It is an off-the-shelf injection that recruits the patient's own T cells against myeloma without the manufacturing wait of CAR-T.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Elrexfio
- Modality: Bispecific T-cell engager (BCMA×CD3)
- Mechanism: Humanised IgG2a BCMA×CD3 bispecific; step-up dosing 12 mg, 32 mg, then 76 mg weekly.
- Approvals: US 2023: Relapsed/refractory myeloma after ≥4 lines (accelerated)
- Dosing: Subcutaneous; 12 mg day 1, 32 mg day 4, 76 mg weekly from day 8; every 2 weeks after 24 weeks if responding
- Toxicity (grade 3+): Cytokine release syndrome 0%; Infections 40%; Neutropenia 49%

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Elranatamab
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Elranatamab

## Connected records

- cancers: [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Relapsed or refractory multiple myeloma](https://onco.cc/cancers/myeloma-relapsed-refractory/)
- technologies: [T-cell engagers (bispecific)](https://onco.cc/technologies/t-cell-engager/)
- targets: [BCMA](https://onco.cc/targets/bcma/), [CD3](https://onco.cc/targets/cd3/)
- companies: [Pfizer (incl. Seagen)](https://onco.cc/companies/pfizer/)
- terms: [Cytokine release syndrome (CRS)](https://onco.cc/terms/crs/), [Step-up dosing (T-cell engagers)](https://onco.cc/terms/step-up-dosing/)
- trials: [A Study to Determine the Recommended Dose and Schedule, and Evaluate the Safety and Preliminary Efficacy of Mezigdomide in Combination With Elranatama](https://onco.cc/trials/nct06988488/), [A Study to Learn About the Effects of the Combination of Elranatamab, Daratumumab and Lenalidomide Compared With Daratumumab, Bortezomib, Lenalidomide](https://onco.cc/trials/nct05623020/), [A Study to Learn About the Study Medicine Elranatamab Alone and With Daratumumab in People With Multiple Myeloma Who Have Received Other Treatments](https://onco.cc/trials/nct05020236/), [AZD0305 as Monotherapy or in Combination With Anticancer Agents in Participants With Multiple Myeloma](https://onco.cc/trials/nct06106945/), [MagnetisMM-3](https://onco.cc/trials/magnetismm-3/), [MagnetisMM-32: A Study to Learn About the Study Medicine Called Elranatamab in People With Multiple Myeloma (MM) That Has Come Back After Taking Other](https://onco.cc/trials/nct06152575/), [Study With Elranatamab Versus Lenalidomide in Patients With Newly Diagnosed Multiple Myeloma After Transplant](https://onco.cc/trials/nct05317416/)
- pairings: [Caution: T-cell redirectors and infections](https://onco.cc/pairings/bispecific-infection-prophylaxis/)
- key papers: [MagnetisMM-3: elranatamab, a second BCMA bispecific, with a switch to fortnightly dosing after response](https://onco.cc/key-papers/paper-magnetismm-3-elranatamab-natmed-2023/), [MajesTEC-1: teclistamab, an off-the-shelf BCMA bispecific antibody, in heavily pretreated myeloma](https://onco.cc/key-papers/paper-majestec-1-teclistamab-nejm-2022/)
- biomarkers: [BCMA expression](https://onco.cc/biomarkers/bcma-expression/)

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