Epcoritamab Shows Superior Responses vs Chemoimmunotherapy in Relapsed Follicular Lymphoma
Key Clinical Summary
- In a matching-adjusted indirect comparison, epcoritamab significantly improved overall and complete response rates vs standard-of-care chemoimmunotherapy in third-line or later relapsed or refractory follicular lymphoma.
- Epcoritamab demonstrated numerically higher response rates vs mosunetuzumab and odronextamab.
- No grade ≥3 cytokine release syndrome or immune effector cell–associated neurotoxicity syndrome (ICANS) events were reported with epcoritamab.
Epcoritamab demonstrated significantly higher response rates and favorable safety outcomes compared with standard-of-care chemoimmunotherapy in patients with relapsed or refractory third-line or later follicular lymphoma, according to a matching-adjusted indirect comparison analysis.
Study Findings
The analysis used individual patient-level data from the EPCORE NHL-1 follicular lymphoma cohort and compared outcomes with pooled data from SCHOLAR-5 (standard of care, primarily chemoimmunotherapy), and aggregate data from the GO29781 trial (mosunetuzumab) and ELM-2 trial (odronextamab). Propensity score weighting was applied to match baseline characteristics across trials.
Compared with standard of care/chemoimmunotherapy, epcoritamab produced significantly higher response rates. The overall response rate (ORR) was 90.9% with epcoritamab vs 56.8% with chemoimmunotherapy (P < .001). The complete response (CR) rate was 73.7% vs 32.0%, respectively (P < .001).
When compared with other bispecific antibodies, epcoritamab showed numerically higher ORR vs mosunetuzumab (90.9% vs 80.0%; P = .067) and a numerically higher CR rate (72.8% vs 60.0%; P = .159). Against odronextamab, epcoritamab demonstrated a significantly higher ORR (91.5% vs 80.5%; P = .026), although CR rates were numerically lower (67.5% vs 73.4%; P = .428).
Safety findings were notable. Epcoritamab had no reported grade ≥3 cytokine release syndrome (CRS) events or any-grade ICANS. By comparison, grade ≥3 CRS occurred in 2.2% and 3.9% of patients treated with mosunetuzumab and odronextamab, respectively, and ICANS occurred in 4.4% and 0.8% of patients (P < .001).
Clinical Implications
Relapsed or refractory follicular lymphoma remains a treatment challenge after 2 or more systemic therapies. Standard-of-care chemoimmunotherapy has historically offered modest response rates in this setting.
This indirect comparison suggests that epcoritamab may provide superior response rates and improved safety compared with chemoimmunotherapy and may offer competitive efficacy relative to other bispecific antibodies. The absence of high-grade CRS and ICANS in the epcoritamab cohort may influence treatment selection, particularly for patients at higher risk for immune-related toxicities.
Additionally, epcoritamab is administered subcutaneously, offering potential convenience advantages in outpatient settings. While cross-trial comparisons must be interpreted cautiously, these findings provide important context for clinicians considering bispecific antibody options in advanced follicular lymphoma.
Conclusion
In this matching-adjusted indirect comparison, epcoritamab demonstrated superior response rates vs chemoimmunotherapy and favorable safety relative to other bispecific antibodies in third-line or later follicular lymphoma. These findings support epcoritamab as a strong therapeutic option in relapsed or refractory disease, pending further direct comparative data.
Reference
Danilov AV, Thiruvengadam SK, Linton K. Indirect comparison of epcoritamab vs chemoimmunotherapy, mosunetuzumab, or odronextamab in follicular lymphoma. Blood Adv. 2025;9(15): 3754-3765. doi:10.1182/bloodadvances.2024015274
