So my name is Chan Cheah. I'm a professor of hematology at the Sir Charles Gairdner Hospital in Perth, Western Australia.
At this ASH, one of the abstracts I'm presenting is on epcoritamab plus R-mini-CHOP in patients with diffuse large B-cell lymphoma who have not previously received therapy and are ineligible for full-dose anthracycline.
This was part of a larger basket trial called NHL-2, which involved patients with the most common type of B-cell lymphoma—diffuse large B-cell lymphoma.
The standard of care for younger patients with diffuse large B-cell lymphoma is R-CHOP at full dose. In elderly patients or those with significant comorbidities, we use an attenuated regimen called R-mini-CHOP, in which the doses of chemotherapy are reduced by approximately 50%. Unfortunately, this approach is suboptimal, as only about 50% of patients are cured.
In this phase 1b/2 trial involving 28 patients, we evaluated the combination of the T-cell engaging antibody epcoritamab with R-mini-CHOP. Epcoritamab was given for eight cycles, while R-mini-CHOP was given for six cycles. Epcoritamab was administered with step-up dosing: initially weekly, then every three weeks, and in the last two cycles, given alone monthly.
The majority of patients in this study were over 75 years of age and considered unsuitable for full-dose anthracycline. Most also had high-risk features such as stage 4 disease, elevated lactate dehydrogenase, and an International Prognostic Index score of 3 to 5.
The overall response rate was high—about 92%—regardless of high-risk subgroups, with 80–82% of patients achieving a complete metabolic response.
With a median follow-up of about two years, progression-free and overall survival rates were excellent and superior to historic controls of R-mini-CHOP alone.
In terms of safety, the most common adverse event associated with epcoritamab was cytokine release syndrome (CRS), which occurred in 51% of patients. Most cases were grade 1, with only one grade 2 event, and it was straightforward to manage. Neutropenic sepsis was relatively infrequent, and overall, the regimen was well tolerated.
Minimal residual disease (MRD) data were also presented. Among 21 patients assessed, the majority achieved MRD negativity, most after three cycles of therapy, with the rate increasing by cycle six, day one.
In summary, the epcoritamab plus R-mini-CHOP regimen is highly effective in patients with triple-naive diffuse large B-cell lymphoma who are ineligible for conventional-dose therapy, and these results justify ongoing exploration.
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HealthTree • December 20, 2025