Subcutaneous epcoritamab + R-DHAX/C in patients (pts) with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) eligible for autologous stem cell transplant (ASCT): Preliminary phase 1/2 results.

Authors

null

Pau Abrisqueta

Vall d'Hebron University Hospital, Barcelona, Spain

Pau Abrisqueta , Lorenzo Falchi , Tycel Jovelle Phillips , Sven De Vos , Marcel Nijland , Fritz Offner , Irina Bykhovski , Jun Wu , Liwei Wang , Ali Rana , Raul Cordoba

Organizations

Vall d'Hebron University Hospital, Barcelona, Spain, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, Ronald Reagan University of California Los Angeles Medical Center, Los Angeles, CA, University Medical Center Groningen and University of Groningen, Groningen, Netherlands, Universitair Ziekenhuis Gent, Gent, Belgium, Genmab, Princeton, NJ, AbbVie, North Chicago, IL, Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: Current standard of care for pts with R/R DLBCL eligible for ASCT includes salvage immunochemotherapy, such as rituximab, dexamethasone, cytarabine, and oxaliplatin or carboplatin (R-DHAX/C), followed by consolidation with high-dose therapy (HDT) and ASCT. However, salvage therapy fails in many pts, and novel treatment (Tx) options are needed to improve response and long-term outcomes. Epcoritamab, a bispecific antibody targeting CD3 on T cells and CD20 on B cells, had a manageable safety profile and meaningful single-agent antitumor activity in pts with heavily pretreated B-cell non-Hodgkin lymphoma (NHL) in the dose-escalation part of the EPCORE NHL-1 trial. Here we present initial results from arm 4 (epcoritamab + R-DHAX/C) of the EPCORE NHL-2 phase 1/2 trial (NCT04663347). Methods: Adults with R/R CD20+ DLBCL who were eligible for HDT-ASCT were enrolled. Pts received standard R-DHAX/C with subcutaneous epcoritamab (QW, 21-d cycle [C] 1–3). If HDT-ASCT was postponed, pts could continue epcoritamab monotherapy (28-d C: QW, C4; Q2W, C5–9; Q4W, C≥10) until disease progression or unacceptable toxicity. Step-up epcoritamab dosing and corticosteroids were required to mitigate CRS in C1. Response was determined by PET-CT per Lugano criteria. Results: As of Jan 26, 2022, 27 pts (median age, 59 y; range, 30–75) had received epcoritamab + R-DHAX/C. Of these, 74% had received 1 prior line of therapy, the remainder (26%) 2–3 prior therapies; 3 pts had prior CAR T. The majority of pts (70%) had primary refractory disease. The most common Tx-emergent adverse events (any grade [G]) were thrombocytopenia (67%), neutropenia (48%; febrile neutropenia, 19% in all pts), infections (37%), nausea (37%), and anemia (33%). Adverse events of special interest were CRS in 8 pts (30%; all G1/2) and ICANS in 1 pt (G2; discontinued epcoritamab, pt with prior CAR T). No clinical tumor lysis syndrome was observed. CRS events occurred early in Tx; median time to resolution was 2 d. Of the 23 evaluable pts, 11 pts underwent ASCT; among these, overall response rate (ORR) was 100% prior to ASCT (82% [9/11] complete metabolic response [CMR]; 18% [2/11] partial metabolic response [PMR]). In 12 pts, HDT-ASCT was postponed/canceled and epcoritamab monotherapy continued; of these, 5 (42%, including 2 with prior CAR T) had CMR and 3 (25%) had PMR. The CMR and PMR rates for the entire evaluable population were 61% (14/23) and 22% (5/23), respectively. Conclusions: Subcutaneous epcoritamab in combination with R-DHAX/C in pts with R/R DLBCL had a manageable safety profile. CRS events were of low grade and resolved with standard management. ORR and CMR rate were high. At the time of data cutoff, 70% of pts had either received ASCT or continued epcoritamab Tx in CMR. Clinical trial information: NCT04663347.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Cell Therapy, Bispecific Antibodies, and Autologous Stem Cell Transplantation for NHL, HL, or CLL

Clinical Trial Registration Number

NCT04663347

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 7528)

DOI

10.1200/JCO.2022.40.16_suppl.7528

Abstract #

7528

Poster Bd #

182

Abstract Disclosures