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ASCO 2024 | Mitigating toxicities related to epcoritamab in follicular lymphoma: insights from EPCORE NHL-1
Julie Vose, MD, University of Nebraska Medical Center, Omaha, NE, presents findings from the EPCORE NHL-1 trial (NCT03625037), specifically focusing on the optimization cohort of patients with follicular lymphoma (FL) treated with epcoritamab. Through increased step-up dosing, steroid use, and hydration, the trial effectively mitigated cytokine release syndrome (CRS) and neurological toxicity. High response rates were achieved, with an 82% overall response rate (ORR) and a 65% complete response (CR) rate. This interview took place during the 2024 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
The abstract I’m going to present is the EPCORE-1 update on follicular lymphoma optimization cohort. So the optimization cohort was a second cohort that was done after the initial cohort was completed, to try to see if we could decrease the cytokine release syndrome and neurologic toxicity of the EPCORE original trial. So in doing that, we increased the step up dosing to three step up dosing before you get to the final dose...
The abstract I’m going to present is the EPCORE-1 update on follicular lymphoma optimization cohort. So the optimization cohort was a second cohort that was done after the initial cohort was completed, to try to see if we could decrease the cytokine release syndrome and neurologic toxicity of the EPCORE original trial. So in doing that, we increased the step up dosing to three step up dosing before you get to the final dose. And we also increased the use of steroids before each of the step up dosing, as well as increased hydration, and stopped any antihypertensive temporarily on the patients. Patients did not need to be mandated to be hospitalized, and the majority of patients with this additional step up dosing had decreased cytokine release syndrome, there was no grade three, and there was no neurologic toxicity with these patients in the modified step up dosing. And it really increased the ability of the patients to tolerate the therapy quite a bit. And I think in the end allowed patients to stay on trial longer. The response rate was very high, 82% with a 65% overall complete response rate. And the majority of patients were able to get all of their doses on time and did not have any problems. So for the most part, most people now are using this step up dosing to increase the safety for patients receiving epcoritamab.
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