Dr Vose on the Safety of Epcoritamab in Relapsed/Refractory LBCL

“Although [epcoritamab] doesn’t benefit all patients [with relapsed/refractory large B-cell lymphoma], those who did respond well and became MRD-negative did have a good response. The toxicity was the same [as it’s] been described previously with low rates of cytokine release syndrome in cycle 1 day 15, which is the first full dose.”

Julie M. Vose, MD, MBA, professor and chief of the Division of Oncology and Hematology; and the George and Peggy Payne Distinguished Chair in Oncology at University of Nebraska Medical Center/Nebraska Medicine, highlights 3-year safety data for epcoritamab-bysp (Epkinly) in relapsed/refractory large B-cell lymphoma (LBCL).

In patients with relapsed/refractory LBCL (n = 157), including those with follicular lymphoma and diffuse LBCL, epcoritamab led to the longest reported median duration of complete response (DOCR) to date among FDA-approved bispecific antibodies in this patient population, based on a 3-year follow-up from the phase 1/2 EPCORE NHL-1 trial (NCT03625037). Notably, the median DOCR with epcoritamab was 36.1 months (95% CI, 20.2-not reached [NR]). The overall response rate was 59%, with a complete response rate of 41% and a partial response rate of 17%.

Long-term progression-free survival (PFS) and overall survival (OS) data showed the median PFS in the overall population was 4.2 months (95% CI, 2.8-5.5). In complete responders (n = 65), median PFS was 37.3 months (95% CI, 26.0-NR) with an estimated 36-month PFS rate of 53%. Median OS for the overall population was 18.5 months (95% CI, 11.7-27.7); median OS was NR for complete responders.

Although treatment with epcoritamab didn’t benefit all patients in the population, patients who had responses and became minimal residual disease (MRD)–negative demonstrated good responses, Vose begins. Regarding safety, she notes that the toxicity of the agent was similar to previous findings, specifically with low rates of cytokine release syndrome (CRS) that occurred on day 15 of cycle 1, which was the first full dose. Similarly, patients on the study experienced low rates of immune effector cell–associated neurotoxicity syndrome (ICANS), she says. After cycle 1, minimal toxicity concerning CRS and ICANS occurred, she explains. Nevertheless, patients need to be monitored for potential infections, especially because patients are heavily pretreated with lymphocyte depletion, Vose concludes.