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<p>Elranatamab, a BCMA-CD3 bispecific antibody, has demonstrated robust activity in relapsed/refractory multiple myeloma (RRMM), but real-world outcomes remain poorly defined. We conducted a multicenter retrospective study of 130 patients treated with commercial elranatamab across nine U.S. academic centers. The cohort was heavily pretreated (91% triple-class refractory, 49% penta-refractory), with 49% previously exposed to BCMA-targeted therapies. Only 22% would have met eligibility for MagnetisMM-3 cohort A. The overall response rate (ORR) was 65%, including ≥CR in 36%. Median progression-free survival (PFS) and overall survival (OS) were 4.3 and 14.6 months, respectively, shorter than MagnetisMM-3. Elevated LDH and low hemoglobin independently predicted poor outcomes and were incorporated into the novel ALPS (Anemia-LDH Prognostic System) score, which stratified patients into distinct risk groups for ORR, OS, PFS, and duration of response. Prior BCMA exposure reduced depth of response, with inferior OS observed in those treated within one year of prior therapy. Infections occurred in 38% of patients. Intravenous immunoglobulin supplementation, modeled as a time-dependent covariate, was associated with improved infection-free survival and PFS. While the incidence of CRS was modestly lower than in MagnetisMM-3, ICANS occurred more frequently in this real-world cohort. These findings highlight the efficacy, limitations, and supportive care needs of elranatamab in a frailer, more heterogeneous real-world RRMM population.</p>

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Real-world outcomes with elranatamab in multiple myeloma: a multicenter analysis from the U.S. Multiple Myeloma Immunotherapy Consortium

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月27日

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  • Andrew J. Portuguese,
  • James A. Davis,
  • Shahzad Raza,
  • Omar Castaneda Puglianini,
  • Ciara Freeman,
  • Melissa Alsina,
  • Corbin Wright,
  • Brandon J. Blue,
  • Rachid C. Baz,
  • Kenneth H. Shain,
  • Utkarsh Goel,
  • Jack Khouri,
  • Faiz Anwer,
  • Hossam M. Ali,
  • Oren Pasvolsky,
  • Mahmoud Gaballa,
  • Krina Patel,
  • Hector Garcia-Pleitez,
  • Damian Mikulski,
  • Lindsay Fogel,
  • Eli Zolotov,
  • Aishwarya Sannareddy,
  • Aimaz Afrough,
  • Larry D. Anderson Jr,
  • Kelley Julian,
  • Danai Dima,
  • Rahul Banerjee,
  • Emily C. Liang,
  • Raffaella Cassano Cassano,
  • Megan M. Herr,
  • Hamza Hassan,
  • Leyla Shune,
  • Jeries Kort,
  • Shonali Midha,
  • Omar Nadeem,
  • Surbhi Sidana,
  • Yi Lin,
  • Frederick L. Locke,
  • Doris K. Hansen,
  • Douglas Sborov,
  • Noa Biran,
  • Ariel Grajales-Cruz

摘要

Elranatamab, a BCMA-CD3 bispecific antibody, has demonstrated robust activity in relapsed/refractory multiple myeloma (RRMM), but real-world outcomes remain poorly defined. We conducted a multicenter retrospective study of 130 patients treated with commercial elranatamab across nine U.S. academic centers. The cohort was heavily pretreated (91% triple-class refractory, 49% penta-refractory), with 49% previously exposed to BCMA-targeted therapies. Only 22% would have met eligibility for MagnetisMM-3 cohort A. The overall response rate (ORR) was 65%, including ≥CR in 36%. Median progression-free survival (PFS) and overall survival (OS) were 4.3 and 14.6 months, respectively, shorter than MagnetisMM-3. Elevated LDH and low hemoglobin independently predicted poor outcomes and were incorporated into the novel ALPS (Anemia-LDH Prognostic System) score, which stratified patients into distinct risk groups for ORR, OS, PFS, and duration of response. Prior BCMA exposure reduced depth of response, with inferior OS observed in those treated within one year of prior therapy. Infections occurred in 38% of patients. Intravenous immunoglobulin supplementation, modeled as a time-dependent covariate, was associated with improved infection-free survival and PFS. While the incidence of CRS was modestly lower than in MagnetisMM-3, ICANS occurred more frequently in this real-world cohort. These findings highlight the efficacy, limitations, and supportive care needs of elranatamab in a frailer, more heterogeneous real-world RRMM population.