Real-world outcomes of patients with aggressive B-cell lymphoma treated with epcoritamab or glofitamab
Abstract
Abstract Epcoritamab and glofitamab are CD20-directed bispecific antibodies (BsAbs) approved in the United States for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). Limited data exist for patients treated outside of trials. Patients with R/R DLBCL receiving commercial epcoritamab or glofitamab between 1 January 2023 and 15 October 2024 were collected from 21 United States institutions. Among 245 patients, 156 received epcoritamab and 89 received glofitamab, 113 were refractory to front-line therapy, 40 had MYC and BCL2 and/or BCL6 rearrangements, 147 received prior chimeric antigen receptor T-cell therapy, and 174 patients would have been ineligible for registrational trials. The overall response rate (ORR) for epcoritamab and glofitamab was 51% (23% complete response, [CR]) and 53% (30% CR), respectively. Median progression-free survival (PFS) was 2.6 months (95% confidence interval [CI], 2.0-3.8 months), and median overall survival (OS) was 7.8 months (95% CI, 6.2-11.0 months). The 6-month PFS was 36% (95% CI, 30-44) and the 6-month OS was 60% (95% CI, 54-67). Both trial ineligibility and undetectable CD20 pre-BsAbs portended shorter PFS and OS. Of 17 individuals with paired biopsies, 15 (88.2%) lost CD20 expression after BsAbs with a median time to progression of 3.7 months. This analysis including patients with R/R DLBCL shows the ORR to CD3/CD20 BsAbs was comparable to pivotal trials, although PFS and OS were lower. Baseline undetectable levels of CD20 were associated with poor outcomes. These results demonstrate the activity of BsAbs in R/R DLBCL, and underscore the importance of target antigen expression.
Article Details
Authors (45)
Taylor R. Brooks
1Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
Emily C. Zabor
2Department of Quantitative Health Sciences, Cleveland Clinic Research, Cleveland, OH
Yohanna B. Bedelu
2Department of Quantitative Health Sciences, Cleveland Clinic Research, Cleveland, OH
Xi Yang
Yasmin H. Karimi
3Division of Hematology-Oncology, Department of Medicine, University of Michigan, Ann Arbor, MI
Adrienne N. Nedved
4Division of Hematology and Oncology, Mayo Clinic, Rochester, MN
Yucai Wang
State Key Laboratory of Immune Response and Immunotherapy, Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine
Nikita Dave
12University of Pennsylvania School of Medicine, Philadelphia, United States
Daniel J. Landsburg
Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia
Kelsey Baron
5Division of Hematology, Department of Medicine, Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
Boyu Hu
Daniel C. Trotier
7Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin Carbone Cancer Center, Madison, WI
Priyanka A. Pophali
7Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin Carbone Cancer Center, Madison, WI
Jordan Miller
Natalie Grover
11Division of Hematology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
Catherine Reinert
8University of Colorado Cancer Center, Aurora, United States
Ajay Major
Tenley Schwarz
5Swedish Cancer Institute, Seattle, United States
Krish Patel
C. U. Shah Medical College, Surendranagar, India
Kiarash Salafian
14University of Virginia, Charlottesville, United States
Emily Ayers
14University of Virginia, Charlottesville, United States
Suchitra Sundaram
15Icahn School of Medicine at Mount Sinai, New York, United States
Joshua D. Brody
Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Marshall McKenna
6Rutgers Cancer Institute of New Jersey, New Brunswick, United States
Yun Kyoung Ryu Tiger
13Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
Megan Sears-Smith
13Levine Cancer Institute, Charlotte, United States
Nilanjan Ghosh
5Levine Cancer Institute/Advocate Health, Wake Forest University School of Medicine, Charlotte, NC
Chelsea Peterson
15Division of Hematology and Cellular Therapy, Allegheny Health Network, Pittsburgh, PA
Cyrus Khan
18Allegheny Health Network, Pittsburgh, United States
Sean P. Bliven
16Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, AL
Mayur Narkhede
23University of Alabama, Birmingham, AL
Alyssa Gibson
16University of Chicago Comprehensive Cancer Center, Chicago, United States
Justin Kline
16University of Chicago Comprehensive Cancer Center, Chicago, United States
Javier Muñoz
Rodolfo Garza-Morales
18Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ
Carrie I. Ho
19Division of Hematology and Oncology, Fred Hutchinson Cancer Center, Seattle, WA
Stephen D. Smith
19Division of Hematology and Oncology, Fred Hutchinson Cancer Center, Seattle, WA
Alex Niu
21Roswell Park Comprehensive Cancer Center, Buffalo, United States
Francisco Hernandez-Ilizaliturri
21Roswell Park Comprehensive Cancer Center, Buffalo, United States
Fadzai Chinyengetere
20Duke University, Durham, United States
Sandeep Dave
Nayef Abdel-Razeq
7Mayo Clinic, Jacksonville, United States
Muhamad Alhaj Moustafa
2Mayo Clinic Florida, Division of Hematology-Oncology, Jacksonville, United States
Paolo F. Caimi
1Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
Brian T. Hill
9Cleveland Clinic Foundation, Cleveland, OH