[Long-term remission in refractory diffuse large B-cell lymphoma with concurrent epcoritamab and radiotherapy]

Area of Science:

• Oncology
• Immunotherapy
• Radiation Oncology

Background:

• Epcoritamab, a CD3xCD20 bispecific antibody, shows efficacy in relapsed/refractory large B-cell lymphoma (R/R LBCL).
• Limited treatment options exist for patients with R/R LBCL who do not achieve durable remission with immunotherapy.

Purpose of the Study:

• To report a case of refractory diffuse large B-cell lymphoma achieving long-term remission with concurrent epcoritamab and radiotherapy.
• To evaluate the feasibility and tolerability of combining epcoritamab with radiotherapy in heavily pretreated patients.

Main Methods:

• A single case of an 87-year-old woman with refractory diffuse large B-cell lymphoma was treated.
• Concurrent administration of third-line epcoritamab and volumetric modulated arc radiotherapy (36 Gy in 18 fractions) to persistent splenic and mediastinal lesions.
• Continued epcoritamab cycles throughout radiotherapy and beyond.

Main Results:

• The patient achieved a complete metabolic response after the combined therapy.
• No significant adverse events were observed during the combined treatment.
• The patient remains in remission beyond 27 treatment cycles.

Conclusions:

• Concurrent epcoritamab and radiotherapy can achieve durable remission in localized refractory large B-cell lymphoma.
• Radiotherapy may serve as a complementary approach to bispecific antibody therapy, overcoming resistance.
• This combination is a potentially feasible and well-tolerated option for elderly or heavily pretreated patients.