An evaluation of epcoritamab as a treatment for relapsed or refractory follicular lymphoma

The treatment landscape for relapsed refractory (RR) follicular lymphoma (FL) is rapidly evolving, and chemo-free immunotherapeutic strategies represent the major players in the field. CD20×CD3 bispecific antibodies are effective and easily manageable agents that are able to redirect the cytotoxic activity of T-cells against lymphoma cells by creating an immunological synapse.

In this paper we will review the efficacy and safety profile of the bispecific antibody epcoritamab in RR FL, either as monotherapy (as it was recently approved in the United States and Europe) and in combination with other agents. We will discuss its potential role among the existing treatment options in this setting, particularly in relation with other approved bispecific antibodies and with CAR-T cell therapy. Presented data were obtained by literature search on PubMed and updated with most recent evidence presented at international hematology meetings (2022-2024).

The optimal treatment sequencing in FL is still an open issue; however, epcoritamab effectively combines key aspects such as high, rapid and durable responses, good tolerability, predictable cytokine release syndrome (CRS) kinetics, and ease of administration, representing an appealing option for patients and clinicians. Future efforts should aim at positioning epcoritamab-based treatments in earlier lines of FL.