Dr Vose on Common Adverse Effects With Epcoritamab in Relapsed/Refractory LBCL

“The major [adverse] effect from [epcoritamab] is cytokine release syndrome, which is typically seen in the first few doses, particularly the first full dose, which is the third dose in this regimen; and neurologic toxicity, which is seen very sparingly and at low grades.”

Julie M. Vose, MD, MBA, the George and Peggy Payne Distinguished Chair of Oncology and the chief of and a professor in the Division of Oncology at the University of Nebraska Medical Center, discussed the safety profile of epcoritamab, a CD3 x CD20 T-cell–engaging bispecific antibody, for the treatment of patients with relapsed/refractory large B-cell lymphoma (LBCL) who have achieved a complete response (CR) at 2 years.

Cytokine release syndrome (CRS) was a significant adverse effect (AEs) that patients with relapsed/refractory LBCL experienced with epcoritamab in the phase 2 EPCORE NHL-1 trial (NCT03625037), Vose began. CRS was observed in patients within the first few doses of epcoritamab, specifically in the first full dose from the third dose in the regimen, she explained. However, CRS was prevented with premedication, and patients were treated as appropriate, she added. Additionally, patients were treated in the hospital for the first full dose of epcoritamab to prioritize safety, Vose asserted.

Other notable AEs included injection site redness and infection among patients who were treated with epcoritamab long-term, Vose stated. She emphasized that patients on the study are very B-cell–depleted, and because they have received many other treatments, they may also be T-cell–depleted and therefore have higher rates of infection. The timing of the study also revealed that patients experienced COVID-19, along with other respiratory and viral illnesses, Vose said.

In particular, in patients with a CR to epcoritamab at 2 years (n = 32), the most common any-grade treatment-emergent AEs (TEAEs) which occurred at any time included COVID-19 (66%), CRS (53%), and diarrhea (44%). Furthermore, 81% of patients had at least 1 TEAE leading to a dose delay during epcoritamab treatment. The most common any-grade TEAEs occurring in at least 10% of patients after 2 years of treatment included COVID-19 (34%), diarrhea (16%), upper respiratory tract infection (16%), decreased neutrophil count (13%), and pneumonia (13%).