PB 9-12-2023:
New Pivotal Data for Bispecific Antibody Epcoritamab (DuoBody® CD3xCD20) Demonstrates High Overall and Complete Responses in Patients with Hard-To-Treat Relapsed/Refractory Follicular Lymphoma (FL)
Media Release
COPENHAGEN, Denmark; December 9, 2023
Data from the pivotal phase 1/2 EPCORE™ NHL-1 study showed 82 percent overall response rate (ORR), 63 percent complete response (CR) and 67 percent minimal residual disease (MRD) negativity in patients with relapsed/refractory (R/R) follicular lymphoma (FL) treated with subcutaneous epcoritamab
Results presented at the 65th American Society of Hematology (ASH) Annual Meeting and Exposition include data from an optimized step-up dosing schedule for FL patients showing meaningful reduction in risk and severity of cytokine release syndrome (CRS)
Follicular lymphoma is the second most common form of non-Hodgkin’s lymphoma, is considered incurable and can be difficult to treat in the R/R setting
Genmab A/S (Nasdaq: GMAB) and AbbVie (NYSE: ABBV) today announced new data from the ongoing phase 1/2 EPCORE™ NHL-1 clinical trial investigating epcoritamab (DuoBody® CD3xCD20), a T-cell engaging bispecific antibody administered subcutaneously, demonstrated an overall response rate (ORR) of 82 percent, a complete response (CR) rate of 63 percent and minimal residual disease (MRD) negativity rate of 67 percent in patients with relapsed/refractory (R/R) follicular lymphoma (FL). The presentation included data from an optimized step-up dosing schedule for FL patients showing a reduction in risk and severity of Grade 2+ cytokine release syndrome (CRS), a common side effect of T-cell engaging cancer treatments. These results were presented today at the 2023 65th Annual Meeting and Exposition of the American Society of Hematology (ASH), being held in San Diego, California, December 9-12, 2023 (Abstract #1655).
“Despite treatment advances for patients with follicular lymphoma whose disease has unfortunately progressed, treating relapsed or refractory follicular lymphoma remains highly challenging, particularly in the third-line plus setting,” said Catherine Thieblemont, M.D., Ph.D., head of the hemato-oncology department, Paris University, Hôpital Saint-Louis Assistance-Publique-Hopitaux de Paris (APHP) in Paris. “The patients in this trial represent a historically difficult-to-treat patient population. The data presented today are especially notable because they demonstrated high overall and complete response rates for this investigational follicular lymphoma therapy and a preview for its potential as an alternative treatment option.”
Overall results from the pivotal cohort of 128 adult patients showed that:
At a median follow-up of 17.4 months, the study’s primary endpoint ORR was 82 percent, which exceeded the protocol defined threshold for efficacy, with a CR rate of 63 percent, and 67 percent MRD negativity.
The median time to response was 1.4 months and median time to CR was 1.5 months.
Median progression-free survival (PFS) for patients who achieved a CR was not reached nor was the median duration of response, duration of CR, MRD negativity and overall survival.
An estimated 85 percent and 74 percent of patients who experienced a CR remained in response at 12 and 18 months, respectively.
Among prespecified subgroups, ORR and CR rates were generally consistent with the overall patient population. Notably, high-risk patients who were refractory to both anti-CD20 therapy and an alkylating agent achieved a 76 percent ORR and 56 percent CR; patients who were refractory to last prior treatment achieved a 74 percent ORR and 51 percent CR rate; and patients whose disease progressed within two years of first-line immunochemotherapy (POD24) achieved an 80 percent ORR and 61 percent CR.
Safety findings were consistent with previous epcoritamab trials, and epcoritamab was generally well tolerated. Following an optimized step-up dose regimen for FL patients (n=50) to reduce the risk and severity of CRS, 40 percent of patients experienced Grade 1 CRS and 8 percent experienced Grade 2 (no Grade 3 or higher CRS were reported) and no Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) was reported. This data may support outpatient administration. Additional common treatment-emergent adverse events (TEAEs) from the pivotal cohort (>20 percent) were injection-site reaction (57 percent), COVID-19 (40 percent), fatigue (30 percent), neutropenia (29 percent), diarrhea (27 percent) and pyrexia (25 percent). TEAEs leading to treatment discontinuation occurred in 19 percent of patients, and Grade 5 TEAEs occurred in 13 patients (10 percent).
“Follicular lymphoma patients who have experienced a relapse following heavy pre-treatment, or whose disease is not responding to available therapies, are considered high risk and are in need of alternative therapeutic options,” said Jan van de Winkel, Ph.D., Chief Executive Officer of Genmab. “The data presented at ASH reinforce what we have seen from our epcoritamab research and believe that this investigational bispecific antibody could potentially represent an important treatment option for patients living with relapsed or refractory follicular lymphoma. Along with our partner AbbVie, we look forward to progressing epcoritamab in clinical trials and discussing the results with regulatory authorities and remain committed to developing epcoritamab as a potential future core therapy for B-cell malignancies.”
About the Phase 1/2 EPCORE™ NHL-1 Trial
EPCORE™ NHL-1 an open-label, multi-center safety and preliminary efficacy trial of epcoritamab that consists of three parts: a phase 1 first-in-human, dose escalation part; a phase 2a expansion part; and a phase 2a dose optimization part. The trial was designed to evaluate subcutaneous epcoritamab in patients with relapsed, progressive or refractory CD20+ mature B-cell non-Hodgkin’s lymphoma (B-NHL), including FL. In the phase 2a expansion part, additional patients were enrolled to further explore the safety and efficacy of epcoritamab in three cohorts of patients with different types of relapsed/refractory B-NHLs who have limited therapeutic options. The dose optimization part evaluates the potential for alternative step-up dosing regimens to help further minimize Grade 2 cytokine release syndrome (CRS) and mitigate Grade =3 CRS. The primary endpoint of the expansion part was ORR as assessed by an IRC. Secondary efficacy endpoints included DOR, complete response rate, duration of complete response, progression-free survival, and time to response as determined by the Lugano criteria. Overall survival, time to next therapy, and rate of minimal residual disease negativity were also evaluated as secondary efficacy endpoints.
About Follicular Lymphoma (FL)
FL is typically an indolent (or slow growing) form of non-Hodgkin’s lymphoma (NHL) that arises from B-lymphocytes.i FL is the second most common form of NHL overall, accounting for 20-30 percent of all NHL cases, and represents 10-20 percent of all lymphomas in the western world.i,ii,iii Although FL is an indolent lymphoma, it is considered incurable with conventional therapyiv,v and patients who achieve remission also often experience relapse.vi