Elrexfio (elranatamab-bcmm)

P2, N=32, Recruiting, Massachusetts General Hospital | Trial primary completion date: Dec 2025 --> Aug 2026

P2, N=30, Recruiting, Massachusetts General Hospital | Not yet recruiting --> Recruiting

P2, N=26, Recruiting, Memorial Sloan Kettering Cancer Center

P2, N=46, Active, not recruiting, Pfizer | N=34 --> 46

P1/2, N=24, Recruiting, Celgene Corp.

P2, N=86, Completed, Pfizer | Active, not recruiting --> Completed

P=N/A, N=30, Not yet recruiting, Pfizer

P2, N=34, Not yet recruiting, M.D. Anderson Cancer Center

JTT may enhance the efficacy of T cell-redirecting immunotherapies in RRMM by promoting cytotoxic T cell expansion. These findings warrant further investigation into the use of JTT as an adjunct to improve outcomes in patients with EMD.

P1, N=60, Recruiting, C4 Therapeutics, Inc. | Not yet recruiting --> Recruiting

Neutrophil recovery occurred by day +10, transfusion independence by day +19, and hematologic recovery allowed elranatamab resumption without recurrence of severe cytopenia. This case demonstrates the potential utility of SCB for managing persistent cytopenias after T-cell-redirecting therapies and supports the importance of early stem cell collection.

We then summarize the clinical development and distinguishing features of currently approved BCMA-targeted modalities-CAR T-cell therapies (ide-cel, cilta-cel), bispecific T-cell engagers (teclistamab, elranatamab, linvoseltamab), and the antibody-drug conjugate (belantamab mafodotin)-highlighting their efficacy, toxicity profiles, and practical positioning in relapsed/refractory MM. Finally, we review emerging resistance mechanisms, including γ-secretase-driven sBCMA elevation, ligand-rich APRIL/BAFF niches, and therapy-induced TNFRSF17 lesions, ranging from biallelic deletions to epitope-altering missense mutations and in-frame deletions within the BCMA extracellular domain. These insights inform rational strategies such as γ-secretase inhibition, dual-target CAR T-cells and bispecific T-cell engagers.