Elrexfio (elranatamab-bcmm)

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.

P3, N=944, Recruiting, Pfizer | Trial primary completion date: Dec 2025 --> Apr 2026

P3, N=1116, Recruiting, Pfizer | Trial completion date: Nov 2031 --> Oct 2033 | Trial primary completion date: Mar 2028 --> Oct 2030

P=N/A, N=159, Not yet recruiting, Peking University People's Hospital

P2, N=39, Completed, Pfizer | Active, not recruiting --> Completed

P3, N=811, Active, not recruiting, Pfizer | Recruiting --> Active, not recruiting

IEC-HS is a rare but potentially fatal complication. Our disproportionality analysis identifies significant reporting signals for tisa-cel and cilta-cel. The high absolute number of cases observed for products like axi-cel appears to reflect high utilization rather than a disproportionate risk, underscoring the necessity of using statistical signal detection methods when interpreting spontaneous reports.

P1, N=60, Not yet recruiting, C4 Therapeutics, Inc.

P2, N=40, Recruiting, Seoul National University Hospital | Not yet recruiting --> Recruiting