Epcoritamab Delivers 3-Year Remission in Tough LBCL Cases

Two years after starting treatment with epcoritamab (EPCOR), a subgroup of patients with relapsed or refractory (R/R) large B-cell lymphoma (LBCL) are showing long-term disease remission, and overall survival, according to post-hoc analysis data from EPCORE-NHL-1.

The subgroup analysis results were presented by Yasmin H. Karimi, MD, clinical assistant professor of Medicine, Division of Hematology/Oncology, University of Michigan, during a poster session at the 2025 ASCO Annual Meeting. The data from Dr. Karimi and colleagues also demonstrated manageable long-term safety and the potential for cure, which the experts note is due to the fixed-duration approach to treating relapsed/refractory LBCL.

“Many of the new studies now are testing the time-limited (fixed duration) approach either by specific months of therapy or a specific time-limited approach after MRD negativity.  With concerns about long term immunosuppression and infection risks, a safe time limited approach that is still efficacious with long-term disease-free survival demonstrated would be ideal,” Julie M. Vose, MD, MBA, FASCO, a co-investigator of EPCORE-NHL-1 and chief, Hematology/Oncology, University of Nebraska Medical Center told Blood Cancers Today.

The study team evaluated 157 patients for long-term study outcomes. Of those included, 65 patients (41%) achieved a complete remission (CR) after a median follow-up of 37 months (range, 32−46 months). Notably, 32 patients (42%) remained in CR at the 2-year mark. Investigators also noted that responses occurred early on in treatment, with only one patient not responding to treatment by week 12.

Responses to fixed-duration treatment were durable. The median duration of response was not reached; however, at 3 years, approximately 96% of patients remained in CR. The longest CR as of the data cutoff date of May 3, 2024, was more than 43 months. In terms of survival, the median progression-free survival and overall survival were not reached in this analysis.

Patients in EPCORE-NHL-1 were on treatment for 35 months (range, 8–43), and many continued treatment into the second year (n = 26, 81%). Safety findings from the 32 patients showed that five patients (19%) developed at least one serious infection. Two patients died as a result of infections, namely COVID-19-related pneumonia and pneumonia.

One patient developed progressive disease and discontinued study treatment. Other discontinuations occurred for 12 patients, mostly as a result of adverse events.

The study investigators reported that EPCOR is beneficial in third-line LBCL, and these results may be helpful as hematologic oncologists decide on personalized care plans. Further research is needed to confirm their findings.

“There is a lot of research needed to evaluate which patient populations tend to benefit from the EPCOR treatment.  Patients who are less heavily pretreated and with less volume of disease tend to have a higher response rate and durability,” explained Vose. “However, molecular and immunologic analysis of the tumor specimens and tumor microenvironment are ongoing to determine who might be a good candidate for this therapy.”