Elrexfio (Elranatamab-Bcmm) for Multiple Myeloma

Elrexfio (elranatamab-bcmm) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with multiple myeloma.

How Elrexfio Works and How It’s Taken

Elrexfio is a type of medicine that helps the immune system fight cancer. It attaches to BCMA, a protein on myeloma cells, and to CD3, a protein on T cells (a type of immune cell). This helps bring the T cells closer to the cancer cells, in order to attack and kill them.

Elrexfio is used for people with multiple myeloma that has relapsed (come back) or did not respond to treatment. It is for people who have already had at least four types of treatment, including a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 antibody.

A healthcare provider gives Elrexfio as a subcutaneous injection (a shot under the skin). The treatment starts with smaller step-up doses on days 1, 4, and 8. After that, it is given once a week through Week 24. If the drug is working well, the dosing may change to every two weeks and later to every four weeks for some people.

Elrexfio Side Effects

In clinical trials of Elrexfio for adults with multiple myeloma, the most common side effects occurred in about 21 percent to 43 percent of people. They include:

Tiredness
Injection site reaction, such as redness or discoloration, itching, pain, bruising, rash, swelling, and tenderness
Diarrhea
Muscle and bone pain
Decreased appetite
Rash
Cough
Nausea
Fever

Serious Side Effects and Warnings

Elrexfio can cause serious side effects that require immediate medical attention. These include:

Cytokine release syndrome (CRS) — This immune reaction can cause fever, chills, low blood pressure, fast heart rate, and trouble breathing.
Neurologic toxicity — This includes immune effector cell-associated neurotoxicity syndrome (ICANS) and other nervous system problems that can be severe.
Serious infections — These include life-threatening or fatal infections such as pneumonia, sepsis, and opportunistic infections.
Neutropenia — Having low neutrophil levels, a type of white blood cell, can raise your risk of serious infection.
Hepatotoxicity — Liver injury can show up as increased liver enzymes or bilirubin and may cause symptoms like dark urine or yellowing of the skin or eyes.
Embryo-fetal toxicity — This medication can harm a fetus in the womb if used during pregnancy.

Get medical help right away if you think you are having a serious side effect from Elrexfio.

How To Save on Elrexfio

Pfizer, the manufacturer of Elrexfio, offers the Pfizer Oncology Together program. Eligible people with commercial insurance may pay as little as $0 per treatment.

To learn more, visit the Elrexfio site or call 877-744-5675.

What To Know Before Taking Elrexfio

Tell your doctor if you have any allergies to elranatamab-bcmm or any ingredients in Elrexfio. Do not take Elrexfio if you have had a serious allergic reaction to elranatamab-bcmm or any of its ingredients.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Also let your doctor know if you have had any recent infections or nervous system problems in the past.

Do not drive, operate heavy or potentially dangerous machinery, or do other dangerous activities during treatment with Elrexfio:

For 48 hours after completing each of the two doses of Elrexfio that are part of the step-up dosing schedule and your first full treatment dose
At any time during treatment with Elrexfio if you develop any new neurologic symptoms, such as dizziness, confusion, shaking, sleepiness, or any other symptom that impairs consciousness, until the symptoms go away

If you are able to become pregnant, your doctor should do a pregnancy test before you start Elrexfio. If you are pregnant, planning to become pregnant, or breastfeeding while taking Elrexfio, talk with your doctor about the risks and benefits. If you are able to become pregnant, use effective birth control during treatment and for four months after your last dose. Do not breastfeed during treatment and for four months after your last dose.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Elrexfio?

In a study of people with multiple myeloma that had come back or did not respond to other treatments, about 58 percent responded to Elrexfio. About 26 percent had no signs of cancer or almost none, about 26 percent had a strong response to the medication, and about 6 percent had a partial response.

Among people who responded, about 90 percent were still responding at six months, and about 82 percent were still responding at nine months.

How long does Elrexfio take to work for multiple myeloma?

In the clinical study, the median time to first response was 1.22 months, with a range of 0.9 to 6.5 months. That means some people responded in about one month, while others took longer.

Can Elrexfio cause skin peeling or rash in people with multiple myeloma?

Yes, Elrexfio can cause skin side effects. Rash was reported in 26 percent of people treated with Elrexfio, dry skin in 14 percent, and skin exfoliation, which can mean peeling skin, in 10 percent.

Injection site reactions, including redness and discoloration, itching, pain, bruising, rash, swelling, and tenderness, were also common and happened in 37 percent of people in clinical trials.

What serious side effects should people taking Elrexfio for multiple myeloma watch for?

Elrexfio may cause side effects that are serious, life-threatening, or can lead to death, including cytokine release syndrome and neurologic problems. CRS happened in 58 percent of people in the study, and most often after the first or second step-up dose. Symptoms can include fever, chills, trouble breathing, low blood pressure, fast heart rate, and headache.

Neurologic toxicity occurred in 59 percent of people, and symptoms can include headache, confusion, feeling very sleepy, trouble speaking or thinking, weakness, shaking, balance problems, or numbness and tingling. Please see the “Serious Side Effects and Warnings” section above for the full list of serious side effects with Elrexfio.

Should I take Elrexfio for multiple myeloma if I have an infection?

You should not start Elrexfio if you have an active infection. During treatment, your doctor will watch for signs of infection. If an infection happens, the treatment may be paused or stopped depending on how serious it is.