Current Epcoritamab Plus Rituximab and Lenalidomide (R2) Perceptions for Patients With Relapsed/Refractory (R/R) Follicular Lymphoma (FL)

OBJECTIVES: Epcoritamab, a novel bispecific antibody, was approved for single-agent use by the FDA in May 2023 for relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). The EPCORE NHL-2 trial is evaluating epcoritamab plus rituximab and lenalidomide (R²) for R/R follicular lymphoma (FL); a pooled analysis of trial cohorts demonstrated a high overall response rate (97%) among R/R FL patients. In February 2024, epcoritamab was granted priority FDA review for difficult-to-treat third-line (3L) or later patients. This survey explored oncologists’ perceptions of epcoritamab's 3L approval for R/R DLBCL and future considerations of epcoritamab plus R² for R/R FL treatment.

METHODS: We administered surveys to US-based oncologists attending in-person forums in July (n=55) and September (n=60) 2023 via an audience response system. Some participants did not answer every question. Data were aggregated and analyzed descriptively.

RESULTS: Participating oncologists had mean 20.5 years in practice, 73% were community-based, and 53% were dual certified in hematology. Before reviewing EPCORE NHL-2, 58% were “not very” or “not at all” familiar with epcoritamab. Only 10% had prescribed epcoritamab for R/R DLBCL. Most (79%) physicians were compelled by the data, with 43% “very likely” and 36% “somewhat likely” to consider epcoritamab plus R² for R/R FL based on safety and efficacy data from EPCORE NHL-2, assuming FDA approval; though, 11% did not consider the data compelling. Assuming FDA approval for R/R FL, 36% of physicians would consider use in second-line treatment, 48% in third-line, and 14% in fourth-line or later.

CONCLUSIONS: Most physicians were unfamiliar with epcoritamab’s approval for R/R DLBCL. Based on EPCORE NHL-2 safety and efficacy data, many would consider epcoritamab for difficult-to-treat R/R FL patients, assuming FDA approval. These findings emphasize the importance of continuing education in community oncology and the potential impact of novel therapeutics on the treatment landscape.