ASH 2025 | Epcoritamab + R2 or epcoritamab maintenance in 1L FL: 3-year outcomes from EPCORE NHL-2 arms 6 & 7

At this meeting, we’ve updated the results from the EEPCORE NHL-2 study from arms 6 and 7. So what this is, arm 6 is looking at the use of time-limited epcoritamab plus R-squared for the treatment of patients with treatment-naive follicular lymphoma. And then arm 7 is looking at the use of epcoritamab monotherapy as maintenance for patients who received one or two prior lines of treatment as standard of care for follicular lymphoma. 

First, we presented the results from arm 6, which again is looking at time-limited epcor plus R-squared. This included patients that were treatment-naive for follicular lymphoma, needed to have therapy according to GELF criteria. They were treated with rituximab for six cycles, lenalidomide for 12 cycles, and epcoritamab monotherapy was added to that for up to two years. So it’s a time-limited regimen for about two years with the primary endpoint of overall response rate. We saw this regimen was associated with high response rates and durable responses. So overall response rate was around 95% with a CR rate of 88%. Median duration of response had not been reached, and at 33 months, about 89% of patients remained in response. We saw that there was a continued response after completion of therapy. At the last follow-up, we had about 36 patients who were in CR. 10 had stopped due to reasons other than progression. And majority of those patients, 9 of 10, remained in remission with another 20 or so months median follow-up after discontinuation of therapy. We saw the patients who were in a CR, 20 of the 21 patients maintained CR at this three-year follow-up, which is an additional median of 12 and a half months post-completion of therapy. So durable responses with time-limited treatment. 

Arm 7 was a completely separate arm of the study. It included 19 patients who had received one or two lines of treatment as standard of care for follicular lymphoma, and then if they had at least a PR and had completed their standard of care treatment within six months, they were eligible to go on to get epcoritamab maintenance for up to two years. And we saw that this deepened response and led to durable responses with the addition of time-limited maintenance. So there were about eight patients that were in PR when they went into their maintenance phase. All of those patients converted to CR at a median of about 2.8 months, so that first disease assessment. So we saw that epcoritamab maintenance did deepen responses and then maintained that response without continuous therapy. 

So there’s an unmet need in follicular lymphoma trying to find chemotherapy-free time-limited options in front lines. So this combination of epcoritamab with R-squared is being further investigated in a phase three study looking at this in combination compared to standard of care therapy. So I think that’s one way that this might enter our frontline treatment landscape in the future. And then in terms of maintenance, our current CD20 maintenance strategies really haven’t translated to a survival benefit. So it just highlights the importance of investigating new things, including epcoritamab, bispecifics, among others, in the maintenance setting to provide durable, prolonged responses for our patients with FL.

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