EPCORE NHL‑2: Epcoritamab + R-DHAX/C for transplant-eligible R/R DLBCL

Efficacy and safety results from Arm 4 of the phase Ib/II, open-label, multicenter, multicohort EPCORE NHL‑2 trial (NCT04663347), evaluating epcoritamab + rituximab + dexamethasone + cytarabine + oxaliplatin/carboplatin (R‑DHAX/C) in transplant-eligible adults with CD20+ relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) after ≥1 prior line of therapy (LoT) (N = 29), were published in Haematologica by Abrisqueta et al. The primary endpoint was investigator-assessed overall response rate (ORR).  

Key data: At a median follow-up of 40.4 months, the ORR was 79% (95% confidence interval [CI], 60.3–92.0), and the complete response (CR) rate was 69% (95% CI, 49.2–84.7). The median progression-free survival (PFS) was 38.7 months (95% CI, 11.5–not reached [NR]), while the median duration of response (DoR), duration of CR (DoCR), and overall survival (OS) were all NR. High response rates were observed consistently across prespecified subgroups. Sixteen patients (55%) proceeded to autologous hematopoietic stem cell transplantation (auto-HSCT). Grade 3/4 treatment-emergent adverse events (TEAEs) occurred in 97% of patients. The most common any grade TEAEs were thrombocytopenia (90%), anemia (66%), neutropenia (59%), and nausea (52%). Cytokine release syndrome (CRS) occurred in 45% (all Grade 1–2), and one patient had Grade 2 immune effector cell-associated neurotoxicity syndrome (ICANS). 

Key learning: Epcoritamab + R‑DHAX/C demonstrated durable efficacy with a manageable safety profile in transplant-eligible patients with R/R DLBCL, supporting the potential of epcoritamab-based salvage treatment as a bridge to curative-intent therapy in this setting.