A NEW treatment combination has emerged for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) who are ineligible for autologous stem cell transplant (ASCT). Results from the Phase Ib/II EPCORE NHL-2 trial demonstrate that the combination of epcoritamab, a CD3xCD20 bispecific antibody, and GemOx (gemcitabine plus oxaliplatin) offers deep and durable responses in this hard-to-treat patient population.
The trial enrolled 103 patients, with a median age of 72 years, who had previously received at least two therapy lines, with 62% of participants classified as ASCT-ineligible. Notably, 28% had received prior CAR T-cell therapy, and 52% had primary refractory disease. The combination therapy yielded an impressive overall response rate (ORR) of 85%, with 61% of patients achieving a complete response (CR). These results highlight the potential of epcoritamab plus GemOx to improve patient outcomes compared to existing therapies, which have historically shown lower response rates.
The treatment showed long-term benefits with a median duration of CR of 23.6 months and a median overall survival (OS) of 21.6 months. While common adverse events included cytopenias and cytokine release syndrome (CRS), most CRS events were low grade and resolved without treatment discontinuation.
These results suggest that epcoritamab plus GemOx may provide a new therapeutic option for patients with R/R DLBCL, especially those who are not candidates for ASCT or have failed prior therapies. Early findings also indicate that this regimen could be most effective when used earlier in the treatment process, as evidenced by higher response rates in second-line and CAR T-naive patients.
For healthcare professionals, these findings are a step forward in the management of difficult-to-treat R/R DLBCL, offering hope for more durable outcomes.
Reference: Brody JD et al. Epcoritamab plus GemOx in transplant-ineligible relapsed/refractory DLBCL: results from the EPCORE NHL-2 trial. Blood. doi:10.1182/blood.2024026830.
Anaya Malik | AMJ
