Efficacy and safety of epcoritamab in Japanese patients with relapsed or refractory diffuse large B-cell lymphoma: 3-year follow-up from the EPCORE NHL-3 trial

Int J Clin Oncol. 2025 Aug;30(8):1631-1640. doi: 10.1007/s10147-025-02788-0. Epub 2025 May 28.

Abstract

Background: Primary results from the EPCORE NHL-3 trial (NCT04542824) showed deep, durable responses in Japanese patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) treated with single-agent epcoritamab, a subcutaneous CD3xCD20 bispecific antibody. Here, we report 3-year follow-up of safety and efficacy.

Methods: Japanese patients with R/R CD20+ DLBCL and ≥ 2 prior systemic therapies received epcoritamab (0.16/0.8-mg step-up doses, then 48-mg full doses) according to the approved label. The primary endpoint was overall response rate per independent review committee.

Results: As of July 12, 2024, 36 patients received epcoritamab (median follow-up, 36.7 months). Overall/complete response rates were 56%/47%. Median duration of response was 15.2 months. Median duration of complete response was not reached; an estimated 53% of complete responders remained in complete response at 3 years. Median progression-free/overall survival (PFS/OS) were 4.1/14.9 months overall; neither was reached among complete responders. Three-year PFS/OS estimates were 25%/39% overall and 53%/71% in complete responders. Among 30 evaluable patients, 17 (57%) became minimal residual disease (MRD) negative, which was associated with longer PFS (cycle 3 day 1 landmark analysis). The most common treatment-emergent adverse events (TEAEs) were cytokine release syndrome (83%), injection-site reaction (69%), and neutropenia (39%), consistent with previous reports. No fatal TEAEs occurred.

Conclusions: With > 3 years of follow-up, epcoritamab treatment has consistently shown durable responses and high rates of MRD negativity in Japanese patients with R/R DLBCL. Safety was similar to previous reports. These long-term remissions reaffirm encouraging outcomes with epcoritamab for this challenging-to-treat population.

Keywords: B-cell lymphoma; Bispecific antibodies; Clinical trial; Non-Hodgkin lymphoma.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bispecific* / administration & dosage
  • Antibodies, Bispecific* / adverse effects
  • Antibodies, Bispecific* / therapeutic use
  • East Asian People
  • Female
  • Follow-Up Studies
  • Humans
  • Japan
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / drug therapy
  • Neoplasm Recurrence, Local* / pathology
  • Treatment Outcome

Substances

  • Antibodies, Bispecific

Supplementary concepts

  • Japanese people