Epcoritamab Plus R-ICE Achieves High Response Rates in DLBCL Patients

Epcoritamab, in combination with R-ICE therapy, has demonstrated significant efficacy in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), particularly those eligible for autologous stem cell transplantation (ASCT), according to findings presented at the European Hematology Association Congress on June 15, 2025. This combination treatment yielded an overall response rate (ORR) of 87% and a complete response (CR) rate of 65% among a cohort of 31 patients treated in the phase 1/2 EPCORE NHL-2 trial (NCT04663347).

The study, led by Dr. Raul Cordoba, a cardio-oncologist at the Fundación Jiménez Díaz University Hospital in Madrid, Spain, highlights the importance of improving outcomes for patients with DLBCL, a condition that presents significant treatment challenges. Approximately half of the patients with relapsed/refractory DLBCL are refractory to salvage chemotherapy, which limits their options for treatment and transplant eligibility.

The trial specifically focused on transplant-eligible patients, including those who had experienced disease progression within 12 months of first-line therapy. Among the 20 patients who fell into this category, the ORR was 85%, with a CR rate of 55%. In contrast, patients who progressed after 12 months showed even more promising results, with an ORR of 91% and a CR rate of 82%.

The regimen included subcutaneous epcoritamab at a dose of 48 mg combined with the R-ICE chemotherapy regimen, which consists of rituximab, intravenous ifosfamide, carboplatin, and etoposide. This treatment was administered until ASCT or disease progression. Most patients completed treatment successfully, with 65% proceeding to ASCT.

Safety profiles were manageable, with no grade 5 or higher treatment-emergent adverse effects reported. The most common adverse effects included neutropenia, thrombocytopenia, and cytokine release syndrome (CRS), with all CRS events being of grade 1 or 2.

The findings underscore the potential of epcoritamab to address the unmet need for effective salvage therapies in relapsed/refractory DLBCL, ultimately enhancing patient eligibility for transplantation, which remains a curative option for many. As treatment strategies continue to evolve, the integration of novel therapies like epcoritamab could signify a paradigm shift in managing this aggressive form of lymphoma.

Dr. Cordoba emphasized, “The results continue to show that adding epcoritamab to any regimen of chemoimmunotherapy increases the proportion of patients who respond to treatment and could proceed to ASCT.”

The trial’s robust outcomes provide hope for patients and clinicians alike as they navigate the complexities of relapsed/refractory DLBCL. Further research is anticipated to solidify these findings and potentially lead to changes in clinical practice guidelines regarding the treatment of this challenging malignancy.