EPCORE NHL-1: epcoritamab, a subcutaneous CD20 x CD3 bispecific, in relapsed large B-cell lymphoma including after CAR-T
In EPCORE NHL-1, the off-the-shelf bispecific antibody epcoritamab produced responses in 63% of patients with relapsed aggressive lymphoma, including many whose CAR-T had failed.
The dose-expansion part of EPCORE NHL-1 treated 157 patients with relapsed or refractory large B-cell lymphoma after at least two prior lines (median three; 39% had prior CAR-T) with subcutaneous epcoritamab given with step-up dosing then weekly, fortnightly and monthly. The overall response rate was 63.1% with complete response in 38.9%; median duration of response was 12.0 months and complete responders had durable remissions. CRS occurred in 49.7% (grade 3 in 2.5%) and ICANS in 6.4% with one fatal event. Responses were similar after CAR-T failure. Epcoritamab received accelerated approval in 2023, alongside the intravenous CD20 x CD3 bispecific glofitamab, whose pivotal study reported complete response in 39% of 155 patients.
- 157 patients with relapsed/refractory LBCL after 2 or more lines; 38.9% had prior CAR-T.
- Overall response 63.1%; complete response 38.9%.
- Median duration of response 12.0 months; most complete responses ongoing at data cut.
- CRS 49.7% (grade 3 2.5%), largely confined to cycle 1; ICANS 6.4% (one fatal).
- Similar response rates in patients whose CAR-T had failed.
CD20 x CD3 bispecifics gave patients whose lymphoma has failed CAR-T, or who cannot access it, an effective off-the-shelf treatment that can be started within days. Epcoritamab and glofitamab are now standard third-line options and are moving into earlier lines and combinations. They do not yet replace CAR-T, whose remissions appear more durable.
- Single-arm phase 2; randomised confirmation in earlier lines came later with mixed results in some designs.
- Fixed-duration (glofitamab) versus until-progression (epcoritamab) dosing remains a practical difference without head-to-head data.
- Infection risk and hypogammaglobulinaemia accumulate with prolonged dosing.
- Durability of partial responses is limited.
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not linked directly; found by shared links- TermStep-up dosing (T-cell engagers)
Shares Glofitamab, Epcoritamab, ICANS (neurotoxicity), Bispecific antibodies.
- IdeaHead-to-head bispecific vs CAR-T in second-line LBCL
Shares Glofitamab, Epcoritamab, T-cell engagers (bispecific), Manufacturing cost and time for living and radioactive medicines.
- TrialSUNMO
Shares CD20 bispecific + CD79b ADC (mosunetuzumab + polatuzumab), Mosunetuzumab, Diffuse large B-cell lymphoma.
- Key paperZUMA-1: axicabtagene ciloleucel for refractory large B-cell lymphoma, the first CAR-T approved for lymphoma
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- ProductPolatuzumab vedotin
Shares CD20 bispecific + CD79b ADC (mosunetuzumab + polatuzumab), Mosunetuzumab, Roche / Genentech, Diffuse large B-cell lymphoma.
- Key paperJULIET: tisagenlecleucel for adults with relapsed or refractory diffuse large B-cell lymphoma
Shares ICANS (neurotoxicity), Objective response rate (ORR), Cytokine release syndrome (CRS), Manufacturing cost and time for living and radioactive medicines.
- Key paperDeLLphi-301: tarlatamab, a DLL3-targeting T-cell engager, in previously treated small-cell lung cancer
Shares ICANS (neurotoxicity), CD3, Bispecific antibodies, Objective response rate (ORR).
- InstitutionComprehensive Cancer Center Mainfranken, University Hospital Würzburg
Shares ICANS (neurotoxicity), Bispecific antibodies, Cytokine release syndrome (CRS), T-cell engagers (bispecific).