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Elranatamab is a humanized bispecific monoclonal antibody that targets both B-cell maturation antigen (BCMA) on multiple myeloma cells and CD3 on T-cells. By binding to these two antigens, it brings T-cells into close proximity with myeloma cells, activating the T-cells to kill the cancer cells. Nirogacestat is an oral small molecule gamma secretase inhibitor that blocks proteolytic activation of Notch receptors and reduces shedding of BCMA from the surface of myeloma cells, thereby increasing the efficacy of BCMA-targeted therapies like elranatamab. The combination is being investigated for relapsed or refractory multiple myeloma, aiming to enhance anti-myeloma activity by maximizing BCMA expression on tumor cells and promoting immune-mediated cytotoxicity[2][3][5][6].
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