Dr Falchi on Long-Term Outcomes of Fixed-Duration Epcoritamab Plus R-CHOP in DLBCL

"The response rates to this combinations were especially encouraging overall, patients exhibited a 100% objective response rate and 87% complete response rate."

Lorenzo Falchi, MD, assistant attending physician, Memorial Sloan Kettering Cancer Center, discusses the long-term outcomes of fixed-duration epcoritamab-bysp (Epkinly) plus R-CHOP (rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, and prednisone) in previously untreated patients with diffuse large B-cell lymphoma (DLBCL) with high-risk features treated in the Epcore NHL-2 trial (NCT04663347).

Findings presented at the 2024 ASH Annual Meeting demonstrated that the combination regimen led to high and durable complete response (CR) rates, Falchi begins. The overall response rate (ORR) was 100%, with an 87% CR rate across all patients (n = 46). Among those who completed 6 cycles of R-CHOP (n = 44), the CR rate was to 91%. These responses were sustained over time, with 83% of patients estimated to remain in CR at 21 months. Notably, CR rates remained consistent across high-risk subgroups, including those with double-hit/triple-hit lymphoma (83%), high International Prognostic Index scores (88%), and bulky disease (88%), he notes.

Minimal residual disease (MRD) assessment further supported the depth of response, Falchi explains. MRD negativity was achieved in 91% of evaluable patients.

Regarding survival outcomes, the estimated progression-free survival (PFS) rate at 21 months was 82% at 21 months, and the 24-month overall survival (OS) rate was 87%. These findings suggest that fixed-duration epcoritamab plus R-CHOP may offer improved disease control compared with standard R-CHOP in this setting, Falchi explains.

From a safety standpoint, the combination was well tolerated, with no new safety signals observed beyond the expected toxicities associated with bispecific antibodies and R-CHOP, Falchi reports. Hematologic toxicities, particularly neutropenia, were the most common treatment-emergent adverse effects. Cytokine release syndrome (CRS) occurred in 45% of patients at grade 1, 11% at grade 2, and 4% at grade 3; no grade 4 or 5 CRS occurred.

These findings support the continued investigation of fixed-duration epcoritamab plus R-CHOP as a potential first-line regimen for patients with high-risk DLBCL, Falchi concludes.