EPCORE NHL-1 and Outpatient CRS Management With Epcoritamab

Dr. Phillips reviews the pivotal EPCORE NHL-1 trial of subcutaneous epcoritamab in heavily pretreated relapsed/refractory large B-cell lymphoma, including patients with prior CAR T-cell therapy and double-hit disease. He notes meaningful complete response rates, somewhat lower in CAR T-exposed patients, with durable responses on this continuous regimen. The physicians compare trial participants with patients treated in practice, noting that early real-world patients were sicker but that selection has improved. Dr. Chavez reviews safety, noting that cytokine release syndrome (CRS) was common but mostly low grade, and that immune effector cell-associated neurotoxicity syndrome (ICANS) was infrequent. Both physicians describe moving away from routine hospitalization for the first full dose, relying instead on risk-based admission, dexamethasone or prednisone prophylaxis informed by the optimization cohort, hydration, and at-home steroid plans. Dr. Chavez also discusses the role of remote monitoring programs in outpatient step-up dosing.