elranatamab-bcmm (Elrexfio)

Indications

• treatment of adult patients with relapsed or refractory multiple myeloma
  • patients who have received at >= 4 prior lines of therapy including a proteasome inhibitor, an immunomodulatory agent, & an anti-CD38 monoclonal Ab

Dosage

• subcutananeous administration
• day 1: 12 mg (1st step-up dose)
• day 4: 32 mg (2nd step-up dose)
• day 8: 76 mg (first treatment dose)
• weekly dose: 76 mg through week 24
• biweekly dose: 76 mg week 25 & every 2 weeks thereafter (responders only)

* patients should be hospitalized for 48 hours after administration of the 1st step-up dose, & for 24 hours after administration of the 2nd step-up dose.

Adverse effects

• >= 20%
  • cytokine-release syndrome, fatigue, injection site reaction, diarrhea, upper respiratory tract infection, musculoskeletal pain, pneumonia, decreased appetite, rash, cough, nausea, pyrexia
• laboratory abnormalities >=30%
  • pancytopenia, anemia, leukopenia, lymphopenia, neutropenia, thrombocytopenia

• drug adverse effects of pharmaceutical monoclonal antibodies

Mechanism of action

• bispecific B-cell maturation antigen (BCMA)-directed CD3 T-cell engager
  • binds to BCMA plasma cells, plasmablasts, & multiple myeloma cells & CD3 on T-cells leading to cytolysis of the BCMA-expressing cells

More general terms

• antineoplastic monoclonal antibody