New antibody therapy shows potential for people with relapsed or refractory B-cell non-Hodgkin lymphomas

A phase 1 trial of a new treatment called epcoritamab has found that it could be a well tolerated treatment option for people with B-cell non-Hodgkin lymphoma that has come back or not responded after several previous courses of treatment.

Epcoritamab is a new type of antibody therapy called a ‘bispecific antibody’. Bispecific antibodies stick to two different target proteins – one on lymphoma cells and one on healthy T cells (immune cells that can kill other cells). This helps the T cells find and destroy the lymphoma cells.

An article published recently in the Lancet reported results from the first 68 people who took part in the trial. Most of these had diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma. On average, they had already had three previous courses of treatment for lymphoma, including 10 people who had had a stem cell transplant, and 5 had had CAR T-cell therapy.

Even in these heavily pretreated people, epcoritamab produced encouraging results. Overall, 68% of people with relapsed or refractory DLBCL and 90% of people with relapsed or refractory follicular lymphoma had a partial or complete response to treatment.

Bispecific antibodies can sometimes cause a serious side effect called cytokine release syndrome. In this trial, 68% of people experienced mild cytokine release syndrome but nobody had moderate or severe symptoms. This might be because epcoritamab is given as an injection under the skin, rather than into a vein, with a gradually increasing dose. People were also given steroids to reduce the risk of reactions.
The most common side effects were:

• fever
• pain, swelling, redness or itching where the injection went it
• pneumonia.

This trial is ongoing and the authors hope that more trials of this promising treatment will take place in the future.

Published: 4 October 2021