Epcoritamab is approved for R/R DLBCL patients after ≥2 lines of previous therapy, including anti-CD20 monoclonal antibody therapy.
The recent FDA approval of epcoritamab for relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) represents a significant advancement in treatment options. Associate Professor Dr. Tycel Jovelle Phillips provided insights into the function, efficacy, and potential impact of this novel bispecific CD20-directed CD3 T-cell engager in a recent discussion. Here are the main takeaways.
- Mechanism: Binds CD3 to engage patient’s T-cells, then CD20 to induce malignant B-cell death.
- Approval based on EPCORE™ NHL-1 study with an overall response rate of 60% and a complete response rate of 38%.
- Durability observed with 89% of complete responders still in remission at initial study cutoff.
- Safety profile: Incidence of cytokine release syndrome (CRS) around 51%, mostly grade 1 or 2, and only 2.5% grade 3; immune effector cell-associated neurotoxicity syndrome (ICANS) rare.
- Epcoritamab offers an off-the-shelf option, increasing accessibility compared to CAR-T.
- Timing of CRS events essential for management, with 92% occurring during cycle 1.
- Further investigation expected in outpatient treatment, combination with other therapies, and possible use in second-line settings.
- Epcoritamab could be implemented in diverse patient populations and not restricted to academic centers.
- The FDA approval of epcoritamab offers a promising new treatment pathway for R/R DLBCL patients, with the potential to expand accessibility beyond current CAR-T options, while maintaining an acceptable safety profile.
Hematology/Oncology Further Reading