Promising data for epcoritamab plus R-CHOP in untreated DLBCL

The combination of epcoritamab plus R-CHOP resulted in high response rates in patients with untreated high-risk diffuse large B-cell lymphoma (DLBCL), including double-hit/triple-hit patients. A phase 3 trial is underway to further evaluate this combination as first-line therapy for patients with DLBCL.

For patients with newly diagnosed DLBCL, R-CHOP remains the standard of care. However, about 45% of the patients do not reach a curative state and the 4-year overall survival rate is only 55% [1,2]. Epcoritamab is a bispecific antibody targeting CD3 and CD20, which has demonstrated efficacy and safety in patients with relapsed or refractory DLBCL as a single agent [3]. Dr Michael Clausen (Lillebaelt Hospital, Denmark) presented the updated results from arm 1 of the phase 1b/2 EPCORE^TM NHL-2 trial (NCT04663347)[4]. This arm of the trial included 47 participants with untreated DLBCL and evaluated the safety and efficacy of epcoritamab (weekly in R-CHOP cycles 1-4, every 3 weeks in cycles 5–6, every 4 weeks in cycle 7 for a total of 1 year) plus R-CHOP (21-day cycles). Anti-tumour activity was the primary endpoint.

The overall response rate was 100% in the study population and therefore also 100% in double-hit/triple-hit participants (n=11). The complete metabolic response rate was 80% and the partial metabolic response rate was 20%. Of those participants who completed therapy, 95% achieved and maintained a complete response after 9 months of follow-up (see Figure).

Neutropenia (67%), anaemia (62%), and cytokine release syndrome (CRS; 59%) were the most common adverse events. There was only one grade 3 CRS event reported.

In conclusion, these promising data of epcoritamab plus R-CHOP support further evaluation of this combination regimen in patients with DLBCL.

Figure: Median duration of response and complete response for participants treated with epcoritamab plus R-CHOP [4]



Median duration of response



Median duration of complete response

 

1. Sehn LH, et al. Blood. 2007;109(5):1857─1861
2. Susanibar-Adaniya S, et al. Am J Hematol. 2021;96(5):617─629
3. Phillips T, et al. Blood. 2022;140 (supplement 1): 8022─8023
4. Clausen M, et al. High complete metabolic response rates with epcoritamab + R-chop in previously untreated patients with high-risk diffuse large B-cell lymphoma, including double/triple-hit: epcore NHL-2 update. P116, EHA 2023 Annual Congress, 8─11 June, Frankfurt, Germany.

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Posted on 2 August 20238 February 2024