Dr Nowakowski on the Potential Benefit of Epcoritamab in Relapsed/Refractory FL

Grzegorz S. Nowakowski, MD, consultant, Division of Hematology; enterprise deputy director, Clinical Research, Mayo Clinic Comprehensive Cancer Center, discusses how the use of epcoritamab-bysp (Epkinly) may fill an unmet need for patients with relapsed/refractory follicular lymphoma (FL).

Notably, the phase 1/2 EPCORE NHL-1 trial (NCT03625037) evaluated epcoritamab in this patient population. Findings from this trial led to the agent’s June 2024 FDA approval for adult patients with relapsed or refractory FL following 2 or more lines of systemic therapy. Epcoritamab may address an unmet need in the management of FL, especially as new developments in the field continue to emerge, Nowakowski begins.

Although there have been advances in therapies, some setbacks have hindered progress, according to Nowakowski. For example, PI3K inhibitors, which initially received accelerated approval from the FDA for the treatment of patients with FL, were later found to have detrimental effects on overall survival in randomized studies, mainly due to infections, he states. This finding led to the withdrawal of PI3K inhibitors from the market for patients with FL and reduced enthusiasm for their use in the third-line FL setting, Nowakowski adds.

Other approved treatments, though available, generate lower response rates, he continues. Mosunetuzumab-axgb (Lunsumio), another bispecific antibody, shows activity in FL but does not fully address the unmet need in this patient population, he says. Therefore, the FDA approval of epcoritamab offers an additional treatment option, expanding therapeutic possibilities for patients with FL, Nowakowski explains.

Furthermore, epcoritamab is already approved for the treatment of patients with aggressive relapsed/refractory lymphomas, including diffuse large B-cell lymphoma and high-grade B-cell lymphoma, he expands. The June 2024 approval facilitates the integration of epcoritamab into treatment regimens for patients with relapsed or refractory FL, as oncologists who manage aggressive lymphomas are already familiar with its use, Nowakowski notes. This familiarity helps streamline the adoption and development of epcoritamab for FL, ensuring patients receive effective care, he adds. Overall, epcoritamab represents a promising new therapeutic option for a patient population that continues to face treatment challenges, Nowakowski concludes.