Common brand names

• Epkinly

How it is administered

Epcoritamab is given as a subcutaneous injection (an injection under the skin), usually in the lower abdomen or thigh. The dosing schedule involves a step-up approach to help reduce the risk of side effects, especially during the first cycle of treatment. The medication is administered in 28-day cycles, with the dose and frequency adjusted as treatment progresses. Early doses are lower and gradually increased to the full dose.

All injections are given by a healthcare professional, and some doses require you to stay in the hospital for monitoring, especially after the first full dose. The medication comes in single-use vials and is prepared by a healthcare provider before injection.

How it works

Epcoritamab is a bispecific antibody that works by engaging your immune system to fight cancer cells. It binds to two targets: CD3, a protein found on T-cells (a type of immune cell), and CD20, a protein found on B-cells, including the cancerous B-cells in large B-cell lymphoma.

By bringing T-cells in close contact with B-cells, epcoritamab activates the T-cells to attack and kill the cancerous B-cells. This process can also cause the release of substances called cytokines, which help the immune system fight cancer but may also cause side effects. The medication is designed to help your immune system recognize and destroy lymphoma cells that may not have responded to other treatments.

Who should take it

Epcoritamab is indicated for adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), including DLBCL arising from indolent lymphoma, and high-grade B-cell lymphoma, after two or more lines of systemic therapy. It is also approved for adults with relapsed or refractory follicular lymphoma after at least two prior treatments.

This medication is typically considered when other standard treatments, such as chemotherapy, targeted therapy, or CAR T-cell therapy, have not worked or are no longer effective. Your doctor will determine if epcoritamab is appropriate for you based on your specific diagnosis and treatment history.

Who should not take it

There are no absolute contraindications listed for epcoritamab, but it should not be used in patients with active infections or those who have had severe reactions to similar medications in the past. It is important to inform your healthcare provider if you have any ongoing infections, are pregnant, or are breastfeeding.

Women who are pregnant or may become pregnant should avoid this medication, as it may cause harm to an unborn baby. Effective contraception is recommended during treatment and for at least 4 months after the last dose. The safety and effectiveness of epcoritamab in children have not been established.

Commonly used with

Epcoritamab is usually used as a single agent (monotherapy) in patients with large B-cell lymphoma who have already received other treatments. It is not typically combined with other cancer drugs, but your doctor may recommend supportive medications such as corticosteroids, antihistamines, and acetaminophen to reduce the risk of side effects like cytokine release syndrome.

Preventive medications for infections, such as antibiotics for Pneumocystis jirovecii pneumonia (PJP) and antivirals for herpes virus, may also be recommended during treatment.

Commonly tested with

Epcoritamab has been studied mainly as a single agent in clinical trials for relapsed or refractory large B-cell lymphoma and follicular lymphoma. In some research settings, it may be tested in combination with other therapies, but its main FDA-approved use is as a monotherapy after other treatments have failed.

Your healthcare team may monitor your blood counts and organ function regularly during treatment, and may also use imaging studies to assess your response to therapy.