Advertisement


Joshua D. Brody, MD, on Follicular Lymphoma: New Data on Epcoritamab, Rituximab, and Lenalidomide

2024 ASCO Annual Meeting

Advertisement

Joshua D. Brody, MD, of the Icahn School of Medicine at Mount Sinai, discusses results from the EPCORE NHL-2 study, which was designed to evaluate the safety and efficacy of epcoritamab-bysp plus rituximab and lenalidomide in the first-line setting for patients with follicular lymphoma and to assess epcoritamab as maintenance therapy in this population (Abstract 7014).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
Today we're going to present data about the arm six and seven from the NHL-2 trial. And these are exciting because they are combinations of epcoritamab, a bispecific antibody, with different standards of care for different subsets of lymphoma. So the arm six and arm seven are treating patients in primarily frontline follicular lymphoma, and the arm six trial is combining epcoritamab with a standard of care, rituximab plus Revlimid, lenalidomide. We sometimes call it R-squared. And the arm six is 41 patients with epcoritamab plus R-squared. Primary endpoints here are efficacy. And this was very exciting because R-squared, a standard of care, are very good therapy, but a very imperfect therapy. We have probably less than half of patients, about 48%, in the big RELEVANCE trial from a few years ago with R-squared getting complete remissions. So good, but a lot of room for improvement. And the big punchline of the epcoritamab plus R-squared arm six is that 85% of patients were having complete remissions, quite awesome, and the vast majority of those remissions were ongoing for at least more than 18 months. Median follow up here was about 22 months. So most of these remissions appear to be durable. And again, most patients on the study had complete remissions. And this is despite the fact that these were a standard cohort of patients, about average age for most follicular lymphoma trials, and the majority with advanced stage, the majority with FLIPI scores of two to five. So in this now medium-sized trial, 40 patients, great results and pretty good durability of those remissions. And the safety here looked to be very good. Most of the side effects that we saw were similar to those to R-squared alone. And the epcoritamab-specific side effects that we saw were a couple, primarily cytokine release syndrome. CRS in this trial was completely low-grade, grade one, grade two. About half of patients had CRS, but, again, low-grade and most of those grade one. So other than that, the safety seemed to be similar to R-squared in most ways. There was neutropenia in about 44% of patients, but no febrile neutropenia, the thing we worry most about. And so this is such positive data that we're excited to see further development of this regimen. There are ongoing trials now for epcor plus R-squared in the frontline, a randomized trial, and also for second-line follicular lymphoma patients. And I'll just say a little bit about arm seven of the trial. This is studying maintenance epcoritamab therapy after any standard of care induction, mostly for patients in the first-line. There was a small number of patients in the second-line or beyond, but primarily frontline patients who were in partial or complete remission from whatever their standard of care, R-chemo or otherwise, was. And the exciting result here was that, out of 20 patients, all of the patients who were in a partial remission going to the trial then transferred into complete remission. And these complete remissions, again, for almost all of the patients, appear to be quite durable. Again, median follow up here, just beyond 22 months. So we can use epcoritamab as part of a frontline combination regimen, and we can use it as a maintenance afterwards. And the safety signals, again, low-grade CRS, no patients having grade three or above CRS, and overall grade one CRS in about a third of patients. So, pretty well tolerated, pretty durable remission so far. Another way we can incorporate these novel immunotherapies into or just after frontline therapies.

Related Videos

Kidney Cancer

Brian I. Rini, MD, on Renal Cell Carcinoma: Exploratory Biomarker Results

Brian I. Rini, MD, of Vanderbilt Ingram Cancer Center, discusses phase III findings of the KEYNOTE-426 study of pembrolizumab plus axitinib vs sunitinib for patients with advanced renal cell carcinoma. He details the exploratory biomarker results, including RNA sequencing, whole-exome sequencing, and PD-L1 (Abstract 4505).

Multiple Myeloma

Luciano J. Costa, MD, PhD, on Multiple Myeloma: Subgroup Analysis of CARTITUDE-4 on Ciltacabtagene Autoleucel

Luciano J. Costa, MD, PhD, of the University of Alabama at Birmingham, discusses recent findings from the CARTITUDE-4 trial showing that, in patients with lenalidomide-refractory functional high-risk multiple myeloma after one prior line of treatment, ciltacabtagene autoleucel improved outcomes vs the standard of care (Abstract 7504).

Issues in Oncology

Andrew Srisuwananukorn, MD, and Alexander T. Pearson, MD, PhD, on Artificial Intelligence in the Clinic: Understanding How to Use This 21st Century Tool

Andrew Srisuwananukorn, MD, of The Ohio State University, and Alexander T. Pearson, MD, PhD, of the University of Chicago, discuss the use of artificial intelligence (AI) in the clinic, its potential benefits in diagnosis and treatment, resources available to help physicians learn more about AI, and what’s coming for the next generation of medical school students.

Kidney Cancer

Toni K. Choueiri, MD, FASCO, on RCC: Biomarker Analysis From the CLEAR Trial

Toni K. Choueiri, MD, FASCO, of the Dana-Farber Cancer Institute, discusses phase III findings showing that, in patients with advanced renal cell carcinoma (RCC), the benefit of lenvatinib plus pembrolizumab vs sunitinib in overall response rate does not appear to be affected by such factors as geneexpression signatures for tumorinduced proliferation, PDL1 status, or the mutation status of RCC driver genes.

Skin Cancer

Pauline Funchain, MD, and Caroline Robert, MD, PhD, on Melanoma: New Data on Encorafenib, Binimetinib, Ipilimumab, and Nivolumab

Pauline Funchain, MD, of Stanford University, and Caroline Robert, MD, PhD, of Gustave Roussy, discuss phase II findings showing that combining encorafenib and binimetinib followed by ipilimumab and nivolumab vs ipilimumab and nivolumab can improve progression-free survival in patients with BRAF-V600E/K-mutated melanoma characterized by high lactate dehydrogenase and liver metastases (Abstract LBA9503).

Advertisement

Advertisement




Advertisement