How it is administered

Elotuzumab is given as an intravenous (IV) infusion, which means it is delivered directly into your vein through a needle. It is supplied as a sterile, preservative-free powder that must be reconstituted and diluted before administration. The medication is administered in cycles, typically every week for the first two cycles, and then every two or four weeks depending on the combination therapy used. Premedication with other drugs (like dexamethasone, antihistamines, and acetaminophen) is required before each infusion to help prevent infusion reactions.

How it works

Elotuzumab is a type of targeted therapy known as a monoclonal antibody. It is specifically designed to recognize and attach to a protein called SLAMF7, which is found on the surface of multiple myeloma cells and certain immune cells called natural killer (NK) cells. By binding to SLAMF7, elotuzumab helps the immune system find and destroy myeloma cells in two main ways:

1. It directly activates NK cells, boosting their ability to attack cancer cells.
2. It marks the myeloma cells for destruction by other immune cells through processes called antibody-dependent cellular cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis (ADCP).

Elotuzumab is not used alone; it is combined with other medications (like lenalidomide or pomalidomide, and dexamethasone) to enhance its effectiveness against multiple myeloma.

Who Should take it

Elotuzumab is intended for adults with multiple myeloma who have already received previous treatments. It is used in combination with lenalidomide and dexamethasone for patients who have received one to three prior therapies. It is also used with pomalidomide and dexamethasone for patients who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor.

This medication is not used as a first-line treatment but is an option for people whose myeloma has returned or has not responded to other treatments. Your doctor will determine if elotuzumab is appropriate for you based on your treatment history and overall health.

Who should not take it

There are no specific contraindications listed for elotuzumab itself, meaning there are no absolute reasons why someone should never receive it. However, it must always be used in combination with other medications (lenalidomide or pomalidomide and dexamethasone), which do have their own contraindications, such as pregnancy (due to risk of birth defects) and certain allergies.

Patients should not take elotuzumab if they have had a severe allergic reaction to it in the past. It is also not approved for use in children, and its safety in people with moderate to severe liver impairment is unknown. Always discuss your full medical history with your doctor before starting treatment.

Commonly used with

Elotuzumab is always used in combination with other medications for multiple myeloma. The most common combinations are:

• Lenalidomide and dexamethasone
• Pomalidomide and dexamethasone

These combinations help improve the effectiveness of treatment by attacking the cancer in different ways.

Commonly tested with

Elotuzumab has been studied in clinical trials with lenalidomide and dexamethasone, as well as with pomalidomide and dexamethasone. These combinations are the standard regimens for relapsed or refractory multiple myeloma and have shown improved outcomes compared to using lenalidomide/dexamethasone or pomalidomide/dexamethasone alone.