Heavily Pretreated Refractory Diffuse Large B-Cell Lymphoma Successfully Treated with Epcoritamab: Case Report.

Area of Science:

• Oncology
• Immunotherapy
• Hematology

Background:

• Diffuse large B-cell lymphoma (DLBCL) presents significant treatment challenges, particularly in relapsed or refractory cases.
• Current treatment strategies including chemoimmunotherapy, stem cell transplantation, and CAR T-cell therapy have limitations for some patients.
• Epcoritamab, a bispecific CD20-directed CD3 T-cell engager, has received accelerated approval for relapsed/refractory DLBCL.

Observation:

• A 61-year-old male with stage 4 double-hit DLBCL (MYC/BCL6 rearrangement) experienced disease progression despite multiple lines of therapy, including R-GDP, CD19 CAR T-cell therapy, tafasitamab/lenalidomide, and pola-BR.
• The patient was not a candidate for autologous stem cell transplantation.
• Initial response to epcoritamab was limited, but after a temporary pause, treatment was resumed, leading to significant disease control.

Findings:

• Following resumption of epcoritamab treatment, the patient achieved a Deauville score of 1, indicating complete metabolic remission.
• The patient has remained in follow-up for nearly two years, demonstrating sustained response.
• This case highlights the potential of epcoritamab in heavily pre-treated DLBCL patients, including those refractory to CAR T-cell therapy.

Implications:

• Epcoritamab represents a valuable therapeutic option for patients with refractory DLBCL who have exhausted other treatment modalities.
• T-cell engager therapies show promise in overcoming resistance to prior treatments like CAR T-cell therapy.
• Further investigation into the role of epcoritamab in diverse DLBCL populations is warranted.