Epcoritamab Plus R2 Shows Promise for R/R FL Treatment
Key Takeaways
- High overall response rates (ORR) and complete response (CR) rates: Almost all of the 108 patients had a significant reduction in tumor size. Response rates were higher than those published in previous bispecific antibody-based studies, with ORR at 96% and CR rate at 88%.
- High rates of minimal residual disease (MRD) negativity: Out of the 72 MRD-evaluable patients, 62 (86%) achieved MRD negativity.
- Low rates of cytokine release syndrome (CRS): Any CRS events were mostly low grade, and 36 patients (33%) experienced a serious CRS event that required hospitalization. No CRS event led to a patient discontinuing the study.
- Impact of COVID-19 warrants further research: Of the 94 patients (87%) who had a treatment-emergent adverse event (TEAE), 64 (59%) contracted a COVID-19 infection. Future studies evaluating the impact of vaccination on epcoritamab plus R2 treatment are needed.
Purpose and Results of Treatment
There is currently no standardized care regimen for R/R FL. R2 is a commonly used treatment for R/R FL, and epcoritamab has been approved as a separate monotherapy. Looking to achieve better patient outcomes and more convenience of care, this study assessed the effects of a combined epcoritamab plus R2 treatment option.
From May 2021 to Sep 2024, 108 patients with R/R FL were treated with epcoritamab plus R2. The median follow-up time was 22 months, which is considered a short time span for R/R FL. Further study is required so the long-term effects of this treatment can be observed.
Administering fixed-duration epcoritamab plus R2 showed durable responses in nearly all R/R FL patients who completed treatment. In terms of efficacy, patients experienced a high ORR (96%) and CR (88%), indicating possible long-term benefits of this regimen.
Out of the 108 patients in this study, 72 (67%) were eligible for MRD analyses. High rates of MRD negativity were observed in this subgroup, with 62 (86%) patients having MRD negativity, another favorable outcome resulting from epcoritamab plus R2 treatment.
The Safety Profile and COVID-19
Out of the CRS events that occurred during this study, 36 (33%) resulted in hospitalization. Most of the CRS events reported were low grade and were resolved after two days. Every patient who experienced a CRS event continued with the treatment.
While the overall safety profile for epcoritamab plus R2 is manageable and consistent with prior studies involving bispecific antibodies, the COVID-19 pandemic impacted the study’s results. The most common TEAE experienced among participants was COVID-19, which infected 64 (59%) patients. The 5 deaths caused by TEAEs were all a result of COVID-19.
This study was designed before the beginning of the COVID-19 pandemic, so vaccination was not required for patients. Further research on the vaccine’s impact on treatment and effect on TEAEs is needed.
Clinical Implications
Although still requiring more in-depth and prolonged research, this study illustrates the potential benefits of treating R/R FL with epcoritamab plus R2. The authors note that “deep responses appear more frequent with epcoritamab plus R2 than with R2 alone.” These encouraging results usher in a new element of care for patients with R/R FL.
Reference
Falchi L, Sureda A, Leppä S, et al. Fixed-duration epcoritamab plus R2 drives favorable outcomes in relapsed or refractory follicular lymphoma. Blood. 2025;146(22):2629–2640. doi:10.1182/blood.2025029909
