Advertisement


Reid Merryman, MD, on High-Risk Follicular Lymphoma: New Data on Epcoritamab, Rituximab, and Lenalidomide

2023 ASCO Annual Meeting

Advertisement

Reid Merryman, MD, of Dana-Farber Cancer Institute, discusses his findings on the regimen of epcoritamab plus rituximab and lenalidomide for patients with high-risk follicular lymphoma. Regardless of whether their disease progressed within 24 months of first-line chemoimmunotherapy, this regimen showed antitumor activity and a manageable safety profile in patients with relapsed or refractory disease. Epcoritamab, a subcutaneous T-cell–engaging bispecific antibody, may abrogate the negative effects of high-risk features (Abstract 7506).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
At ASCO this year I presented updated results from Epcoritamab plus R2 for patients with relapsed or refractory follicular lymphoma. Each of those three drugs, rituximab, lenalidomide, and epcoritamab, has different modes of action. It was hypothesized that lenalidomide with its immunomodulatory properties might enhance the activity of epcoritamab. In this study, patients received R2 over 12 cycles using standard dosing and two different doses of epcoritamab were tested, two different dose schedules. In arm 2A, patients received more frequent epcoritamab dosing, dosed weekly for the first three cycles, every two weeks for cycles four through seven, and every four weeks thereafter. Whereas an arm 2B, less frequent epcoritamab dosing was used every week for the first two cycles, and every four weeks thereafter. In total 111 patients were treated and they had received a median of one prior line of therapy. Notably, patients had many high risk features in this cohort. Approximately 60% of patients had Stage 4 disease. About 40% of patients had progression of disease within the first two years of chemoimmunotherapy treatment, so-called POD24 patients, and approximately 60% of patients had a high risk FLIPI score. The safety profile for this combination was similar to previous reports. The most common side effects included cytokine release syndrome, infections, and neutropenia. CRS was seen in about half of patients, but was primarily low grade with only 2% of patients having Grade 3 or higher CRS. CRS occurred over a predictable timeline. Almost all CRS occurred over the first two cycles, and most CRS occurred after the first full dose of epcoritamab, which was given on cycle one, day 15. Notably, CRS resolved in all patients and no patients discontinued epcoritamab based on cytokine release syndrome. Among all patients the overall response rate was 98%, and the complete metabolic response rate was 87%, both of which are very high for this disease setting. Notably, all patients did well, including those with high risk features like POD24, primary refractory disease or high FLIPI scores. With almost a median of one year of follow-up, the one-year progression-free survival was 78% and the one-year duration of complete response was 89% suggesting that these responses are durable, at least so far. Responses seem to be durable for all patient subgroups, including those with POD24. I think our data suggests that this combination leads to deep and so far quite durable responses with a manageable safety profile. Based on this encouraging data, there's an ongoing randomized Phase 3 trial comparing R2 to R2 plus epcoritamab among patients with relapsed or refractory follicular lymphoma. More broadly, I think this trial adds to a growing number of studies that suggest that CD3/CD20 bispecific antibodies are a very potent treatment for follicular lymphoma and will likely be an important part of our treatment for FL patients in the years to come.

Related Videos

Leukemia

Eunice S. Wang, MD, and Gregory Roloff, MD, on B-ALL: Outcomes With Brexucabtagene Autoleucel in Adult Patients

Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, and Gregory Roloff, MD, of the University of Chicago, discuss data that are the first to demonstrate post–FDA approval efficacy and toxicity rates of brexucabtagene autoleucel in adults with relapsed or refractory B-cell acute lymphoblastic leukemia. Although the data may confirm high response rates associated with this agent, they also highlight the need for interventions to reduce associated toxicities (Abstract 7001).

Gynecologic Cancers

Bobbie J. Rimel, MD, and Kathleen N. Moore, MD, on Ovarian Cancer: New Findings on Mirvetuximab Soravtansine vs Chemotherapy

Bobbie J. Rimel, MD, of Cedars-Sinai Medical Center, and Kathleen N. Moore, MD, of the Stephenson Oklahoma Cancer Center at the University of Oklahoma, discuss phase III results from the MIRASOL trial, which showed that mirvetuximab soravtansine-gynx prolonged overall survival vs investigator’s choice chemotherapy in patients with platinum-resistant ovarian cancer with high folate receptor-alpha expression. The findings suggest a new standard of care for this disease (Abstract LBA5507).

Bladder Cancer

Arlene O. Siefker-Radtke, MD, on Metastatic Urothelial Carcinoma: New Data on Erdafitinib vs Chemotherapy From the THOR Study

Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III findings showing that for patients with advanced or metastatic urothelial carcinoma and FGFR alteration who already had been treated with a PD-(L)1 inhibitor, erdafitinib significantly improved overall and progression-free survival, as well as overall response rate, compared with investigator’s choice of chemotherapy (LBA4619).

Ajay K. Nooka, MBBS, Relapsed or Refractory Multiple Myeloma: Efficacy and Safety Data for Elranatamab

Ajay K. Nooka, MBBS, of Winship Cancer Center of Emory University, discusses findings from a pooled analysis of MagnetisMM studies. The data showed that, in patients with relapsed or refractory multiple myeloma who have not yet been treated with B-cell maturation antigen–directed therapies, elranatamab was efficacious and well tolerated.

Lung Cancer
Immunotherapy

Narjust Florez, MD, and Heather A. Wakelee, MD, on Early-Stage NSCLC: Phase III Findings From KEYNOTE-671 on Pembrolizumab and Platinum-Based Chemotherapy

Narjust Florez, MD, of Dana-Farber Cancer Institute, and Heather A. Wakelee, MD, of Stanford University, Stanford Cancer Institute, discuss new data supporting neoadjuvant pembrolizumab plus chemotherapy followed by surgery and adjuvant pembrolizumab as a promising new treatment option for patients with resectable stage II, IIIA, or IIIB (N2) non–small cell lung cancer (NSCLC) (Abstract LBA100).

Advertisement

Advertisement




Advertisement