Subcutaneous Epcoritamab Elicits High Rate of Responses in R/R DLBCL

Tycel Phillips, MD, discusses the results from the practice-changing EPCORE NHL-1 study.

Tycel Phillips, MD, associate professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, discusses the results from the EPCORE NHL-1 (NCT03625037), which recently led to the FDA approval of subcutaneous epcoritamab-bysp (Epkinly) for the treatment of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) after 2 or more lines of systemic therapy.


0:08 | So when the upgrade of is given, it's given as a subcutaneous injectionSo, when the epcoritamab is given, it's given as a subcutaneous injection. With all the bispecific antibodies, we see them given in a step-up dosing fashion to reduce some of the adverse events that we know with this type of treatment. Epcoritamab is similar and it was given on day 1 at a dose of 0.16 mg of cycle 1, on day 8 was given at 0.8 mg, and then cycle 1 day 15 and thereafter, it was given at 48 milligrams. It was given weekly from cycles 1 through 3, and then every other week from cycles 4 through 9, and with cycles 10 plus, it was given monthly to maintain response.

0:47 | We saw an overall response rate in this patient population of 63%. Much more importantly, there was a complete response rate of around 40% in his patient population, indicating that those are the patients we likely would expect to see to have durable responses. There was not much of a difference if we looked at treatment based on age. As we see, the overall response rate and the CR rate was fairly similar in most of these patients. We saw a slightly higher CR rate in older patients, which probably just reflects their disease and what they received previously.

∫If we look at patients with primary refractory disease, which is probably our most difficult to treat patient population, there was a slight decrease in the complete response rate from the overall population. There was 30% in our primary refractory group and 39% overall. Then, we looked at those who were CAR T naive and CAR T exposed. The CR rate was 34% in the exposed patient population and 42% in the CAR T naive patient population. Again, probably speaking more to the biology of the disease, we did see a higher CR rate in patients with more treatments, which probably indicates if they've received 4 or more lines of therapy, lymphoma was probably not as aggressive as some of the other ones. But overall, there wasn't a substantial difference in that overall response rate and CR rate across important subgroups that we typically look at in this patient population.

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