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T-Cell Engagers Targeting BCMA, GPRC5D, or FcRH5 in Relapsed/ Refractory Multiple Myeloma, Landscape Beyond CAR-T Cell Therapy, a Systematic Review and Network Meta Analysis

Shambhavi S, Singh H, Amonica T, Grover A, Singh T, Paul S, Joy AA, Pompa T

2026

Abstract

Background: : Relapsed/refractory multiple myeloma is marked by frequent triple-class refractoriness and poor survival, whereas bispecific antibodies targeting BCMA, GPRC5D, or FcRH5 show meaningful activity even in heavily pretreated and post-BCMA disease.This meta-analysis evaluates and compares the efficacy and safety of these agents in RRMM using direct and indirect evidence.

Methods:: We manually searched 7 databases and identified 44 studies for quantitative analysis. Forest plots were created using R 4.1.x software.

Results:: Versus SOC, odds of ORR were higher with Talquetamab, Teclistamab, Elranatamab, and Linvoseltamab (5.73, 4.86, 3.84, 2.63). PFS improved with Teclistamab (HR 0.50, 95% CI 0.36–0.55), Talquetamab (0.50, 0.36–0.55), Elranatamab (0.45, 0.36–0.55), and Linvoseltamab (0.23, 0.17–0.31). Linoseltamab and Elranatamab showed numerically longer OS relative to SOC ( HR 0.41, 0.24–0.70) and (HR 0.58, 0.43–0.78), but numerically shorter OS with Teclistamab (HR 1.82, 1.37–2.42) and Talquetamab (HR 1.75, 1.20–2.57). In pooled single‑arm data, Talquetamab had the highest ORR (72%) and CRS (68%); Teclistamab showed ORR of 61% with CRS 61% and Linvoseltamab showed ORR of 60% with CRS 51%. Cevostamab and Elranatamab had ORR 49% and 56% with CRS 61% and 52%, respectively.

Conclusion:: In RRMM, all bispecific antibodies showed superior ORR along with improved PFS as compared to SOC. Linoseltamab and Elranatamab showed numerically longer OS relative to SOC, whereas…

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Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.

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