ASH 2024 | Managing the adverse events associated with epcoritamab treatment: focus on CRS

Epcoritamab and other bispecific antibodies are associated with very typical adverse events. Most commonly what you see is cytokine release syndrome and occasionally but rarely you also see some neurotoxicity which typically happens to be very low grade. So cytokine release syndrome is something that requires a cautious approach. Well first pre-medication with steroids, adequate hydration are very important before you achieve a full step-up dose. Most cases of CRS occur when patients receive their full dose of epcoritamab at 48 milligrams the first time. That’s when most cases of CRS occur. And you know sometimes it can be also delayed. Sometimes it happens immediately after patients receive the injection. But often it actually happens, sometimes can happen several days later. So it is important to be attuned to that possibility when patients develop fevers, which would be a feature of grade one CRS, which is the majority of CRS that we see. It is important to recognize that and the adequate treatment for many patients would be again hydration and a very short course of steroids. Of course, you will also have to differentiate this from the risk of an infection and evaluate the risk of infection based on your clinical impression. But CRS is something that community physicians want to think about and keep it in their mind when patients who just received epcoritamab at full dose or early on at any dose during ramp-up presents with fevers.

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