Dose Optimization of Elranatamab to Mitigate the Risk of Cytokine Release Syndrome in Patients with Multiple Myeloma

• DOI: 10.1007/s11523-025-01134-8
• Publication Date: 2025-02-25T19:04:37Z
• Authors: Mohamed Elmeliegy; Andrea Viqueira; Erik Vandendries; Anne Hickman; Umberto Conte; Donald Irby; Jennifer Hibma; Hoi-Kei Lon; Joseph Piscitelli; Pooneh Soltantabar; Athanasia Skoura; Sibo Jiang; Diane Wang
• Keywords: Cytokine Release Syndrome

Elranatamab is a BCMA-CD3 bispecific antibody approved for the treatment of relapsed or refractory multiple myeloma. Cytokine release syndrome one most common adverse events associated with antibodies. We aimed to determine optimal elranatamab dosing regimen mitigating cytokine syndrome. Safety, pharmacokinetics, and exposure–response were analyzed across four clinical studies (MagnetisMM-1, MagnetisMM-2, MagnetisMM-3, MagnetisMM-9). Different priming regimens evaluated these included one-step-up dose 44 mg without premedication, two-step-up 12 on day 1 32 4 20 premedication. The maximum serum concentration was positively any-grade grade ≥ 2 A slower time lower dose-normalized observed subcutaneous versus intravenous administration, supporting help mitigate Based incidence, severity, predictable profile syndrome, 12/32-mg priming-dose premedication determined be before first full 76 8. ClinicalTrials.gov identifiers: NCT03269136, NCT04798586, NCT04649359, NCT05014412.