{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:13:53Z","timestamp":1785402833199,"version":"3.56.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Central nervous system (CNS) involvement in multiple myeloma is a rare manifestation associated with aggressive disease biology and a particularly poor prognosis. With the advent of B-cell maturation antigen (BCMA)\u2013directed therapies, evidence regarding their efficacy in CNS-MM remains limited. We report the case of a 70-year-old woman with relapsed\/refractory MM who had previously been treated with proteasome inhibitors, immunomodulatory drugs, anti-CD38 monoclonal antibodies, an immune checkpoint inhibitor, an anti-BCMA antibody\u2013drug conjugate, and a GPRC5D-directed bispecific antibody. She developed a late isolated CNS relapse 10 years after the initial diagnosis. Initial treatment for CNS involvement with pomalidomide, cyclophosphamide, and dexamethasone in combination with intrathecal chemotherapy achieved a transient response. Subsequently, treatment with elranatamab, a BCMA-directed bispecific antibody was initiated. After three cycles, cerebrospinal fluid analysis by flow cytometry demonstrated clearance of malignant plasma cells, with sustained negativity thereafter. The patient remains in CNS remission after 12 months of follow-up, with concordant clinical and radiological stability. This case highlights the feasibility and potential clinical activity of elranatamab in CNS-MM in a heavily pretreated patient with prior exposure to both BCMA and GPRC5D directed therapies.<\/jats:p>","DOI":"10.3389\/fonc.2026.1889721","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:34:19Z","timestamp":1785400459000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Central nervous system relapse treated with elranatamab after prior BCMA and GPRC5D directed therapies in relapsed\/refractory multiple myeloma"],"prefix":"10.3389","volume":"16","author":[{"given":"Ra\u00fal","family":"P\u00e9rez-Calle","sequence":"first","affiliation":[{"name":"Servicio Hematolog\u00eda Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Domingo-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Servicio Hematolog\u00eda Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"L\u00f3pez-Lorenzo","sequence":"additional","affiliation":[{"name":"Servicio Hematolog\u00eda Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Fernando","family":"Bastidas-Tamayo","sequence":"additional","affiliation":[{"name":"Servicio Medicina Nuclear Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Guti\u00e9rrez-San Jos\u00e9","sequence":"additional","affiliation":[{"name":"Servicio Radiolog\u00eda Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Mata-Serna","sequence":"additional","affiliation":[{"name":"Servicio Hematolog\u00eda Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Garc\u00eda-Corral","sequence":"additional","affiliation":[{"name":"Servicio An\u00e1lisis Cl\u00ednicos Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Santiago-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Servicio Inmunolog\u00eda Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz","place":["Madrid, 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