An evaluation of elranatamab for the treatment of myeloma: current evidence for treating relapsed/refractory disease and future directions.

[INTRODUCTION] The development of B-cell maturation antigen (BCMA)-directed therapies has been a significant advancement for the treatment of multiple myeloma. Elranatamab is a bispecific antibody (BsAb) targeting BCMA and CD3. It has achieved regulatory approval in several jurisdictions worldwide for the treatment of patients with relapsed/refractory multiple myeloma. Clinical trials of elranatamab in various settings are currently ongoing.

[AREAS COVERED] This article describes the current evidence for treating relapsed/refractory multiple myeloma with elranatamab. A search for relevant literature was conducted in PubMed, EMBASE, Cochrane Library, and hematology conference abstracts published between 2017 and 2025. Citation mining of the included studies was also conducted.

[EXPERT OPINION] Elranatamab monotherapy has demonstrated manageable safety and encouraging efficacy in relapsed/refractory multiple myeloma. The overall toxicity profile is comparable to other BCMA-targeting BsAbs. The low grade of cytokine release syndrome (CRS) supports the administration of elranatamab in the outpatient setting. High infection rates remain a challenge, although further refinement of anti-infection prophylaxis and adjustment of the dosing schedule may reduce the risk. Clinical trials are currently investigating elranatamab in different settings to further enhance the efficacy, including as a first-line treatment and combination regimens, although benefits need to be weighed against the increased toxicity risk.