[Different initial responses following epcoritamab therapy for relapsed diffuse large B-cell lymphoma with multiple...

Area of Science:

• Oncology
• Immunotherapy
• Hematology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
• Relapsed or refractory DLBCL presents significant treatment challenges.
• Chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies are advanced treatment options.

Purpose of the Study:

• To report a case of pseudo-progression during bispecific antibody therapy in DLBCL.
• To highlight the importance of distinguishing pseudo-progression from true progression.
• To emphasize the need for careful patient assessment during early treatment phases.

Main Methods:

• A 73-year-old male patient with relapsed DLBCL received DeVIC chemotherapy followed by epcoritamab (a bispecific antibody).
• Clinical and radiological assessments were performed during the initial cycle of epcoritamab.
• Tumor response was evaluated based on lesion size changes and CT imaging.

Main Results:

• Initial growth of a left lower leg lesion was observed on day 3 of epcoritamab treatment.
• The same lesion subsequently shrank by day 14 without intervention.
• A partial response was achieved after one cycle, suggesting the initial growth was pseudo-progression.

Conclusions:

• Pseudo-progression can manifest during the early stages of bispecific antibody therapy for DLBCL.
• This phenomenon is similar to that observed with CAR-T therapy.
• Accurate interpretation of early treatment responses is vital to prevent premature discontinuation of potentially effective therapies.