Epcoritamab, a Novel, Subcutaneous CD3xCD20 Bispecific T-Cell-Engaging Antibody, in Relapsed or Refractory Large B-Cell Lymphoma: Dose Expansion in a Phase I/II Trial
- J Clin Oncol. 2023 Apr 20;41(12):2238-2247. doi: 10.1200/JCO.22.01725.
- 1. Assistance Publique & Hôpitaux de Paris (APHP), Hôpital Saint-Louis, Hémato-oncologie, Université de Paris, Paris, France.
- 2. University of Michigan Comprehensive Cancer Center, Ann Arbor, MI.
- 3. Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Bénite, France.
- 4. Sir Charles Gairdner Hospital, Perth, Australia.
- 5. Division of Internal Medicine, Medical School, University of Western Australia, Perth, Australia.
- 6. Vejle Hospital, Vejle, Denmark.
- 7. The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom.
- 8. Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
- 9. Hackensack Meridian Health Hackensack University Medical Center, Hackensack, NJ.
- 10. Concord Hospital, University of Sydney, Sydney, Australia.
- 11. MSC National Research Institute of Oncology, Kraków, Poland.
- 12. Seoul National University Hospital, Seoul, Republic of Korea.
- 13. University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth, United Kingdom.
- 14. On behalf of the Lunenburg Lymphoma Phase I/II Consortium-HOVON/LLPC, Maastricht, Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.
- 15. National University Hospital, Singapore.
- 16. AbbVie, North Chicago, IL.
- 17. Genmab, Princeton, NJ.
- 18. Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
- 19. On behalf of the Lunenburg Lymphoma Phase I/II Consortium-HOVON/LLPC, Erasmus MC Cancer Institute, University Medical Center, Department of Hematology, Rotterdam, the Netherlands.
Purpose: Epcoritamab is a subcutaneously administered CD3xCD20 T-cell-engaging, bispecific antibody that activates T cells, directing them to kill malignant CD20+ B cells. Single-agent epcoritamab previously demonstrated potent antitumor activity in dose escalation across B-cell non-Hodgkin lymphoma subtypes.
Patients and methods: In the dose-expansion cohort of a phase I/II study (ClinicalTrials.gov identifier: NCT03625037), adults with relapsed or refractory CD20+ large B-cell lymphoma and at least two prior therapy lines (including anti-CD20 therapies) received subcutaneous epcoritamab in 28-day cycles (once weekly step-up doses in weeks 1-3 of cycle 1, then full doses once weekly through cycle 3, once every 2 weeks in cycles 4-9, and once every 4 weeks in cycle 10 and thereafter) until disease progression or unacceptable toxicity. The primary end point was overall response rate by the independent review committee.
Results: As of January 31, 2022, 157 patients were treated (median age, 64 years [range, 20-83]; median of three [range, 2-11] prior therapy lines; primary refractory disease: 61.1%; prior chimeric antigen receptor (CAR) T-cell exposure: 38.9%). At a median follow-up of 10.7 months, the overall response rate was 63.1% (95% CI, 55.0 to 70.6) and the complete response rate was 38.9% (95% CI, 31.2 to 46.9). The median duration of response was 12.0 months (among complete responders: not reached). Overall and complete response rates were similar across key prespecified subgroups. The most common treatment-emergent adverse events were cytokine release syndrome (49.7%; grade 1 or 2: 47.1%; grade 3: 2.5%), pyrexia (23.6%), and fatigue (22.9%). Immune effector cell-associated neurotoxicity syndrome occurred in 6.4% of patients with one fatal event.
Conclusion: Subcutaneous epcoritamab resulted in deep and durable responses and manageable safety in highly refractory patients with large B-cell lymphoma, including those with prior CAR T-cell exposure.
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