Epcoritamab Approval Expands Bispecific Use in Follicular Lymphoma

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Bispecific antibodies including epcoritamab have “a lot of potential for upward mobility” in lymphoma, according to Tycel Phillips, MD.

Tycel Phillips, MD, spoke with CancerNetwork® ahead of the FDA’s accelerated approval of epcoritamab-bysp (Epkinly) for patients with relapsed/refractory follicular lymphoma to discuss how this agent may impact the treatment paradigm.

Phillips, an associate professor in the Division of Lymphoma and Department of Hematology & Hematopoietic Stem Cell Transplantation at City of Hope in Duarte, California, reviewed data from the phase 1/2 EPCORE NHL-1 trial (NCT03625037), which ultimately supported the approval of epcoritamab in the aforementioned population. Topline results reported at the time of the agent’s approval showed an overall response rate (ORR) of 82% (95% CI, 74.1%-88.2%), with 60% of patients experiencing a complete response. Additionally, the median duration of response was not reached (NR; 95% CI, 13.7-NR).

Beyond the supporting data, Phillips highlighted how this approval may increase availability of treatment options for patients with follicular lymphoma, especially those who lack access to alternative therapies. He stated that readily available off-the-shelf bispecific antibodies like epcoritamab may bridge the gap for patients who are unable to access CAR T-cell therapies or travel to a major academic center for treatment.

Phillips also detailed strategies for mitigating some of the common toxicities that may occur following treatment with epcoritamab, which include cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. Although Phillips said that epcoritamab is usable in the third-line setting, he noted that bispecific antibodies like it “have a lot of potential for upward mobility,” as he anticipates further assessment of these treatments in the first or second line.

“As community oncologists get more and more comfortable with these drugs and have the structure to set up to safely administer [them] for the first month when most of the complications happen, more and more patients will be able to be treated, which will be a great benefit based on what we’ve seen in early response rates for these drugs,” Phillips said regarding the utility of bispecific antibodies like epcoritamab. “There’ll be a big benefit for the patient population in the long term as more community settings implement these drugs into their clinical practice.”

Reference

FDA grants accelerated approval to epcoritamab-bysp for relapsed or refractory follicular lymphoma. News release. FDA. June 26, 2024. Accessed June 26, 2024. https://tinyurl.com/26s9myey

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