- Results from Arm 1 of the EPCORE® NHL-2 trial show treatment
with epcoritamab combination led to an overall response rate (ORR)
of 100 percent and a complete response (CR) rate of 87 percent in
high-risk patients with previously untreated diffuse large B-cell
lymphoma (DLBCL)
- Extended follow-up data from EPCORE® NHL-1 trial
demonstrates durability of responses and long-term safety of
epcoritamab monotherapy for patients with challenging-to-treat
relapsed/refractory (R/R) DLBCL
- Both analyses were presented at the 66th Annual Meeting and
Exposition of the American Society of Hematology (ASH)
Genmab A/S (Nasdaq: GMAB) today announced new
long-term results from two ongoing clinical trials evaluating
epcoritamab, a T-cell engaging bispecific antibody administered
subcutaneously, in adult patients with diffuse large B-cell
lymphoma (DLBCL). Results from Arm 1 of the Phase 1b/2 EPCORE®
NHL-2 trial (NCT04663347), evaluating fixed-duration epcoritamab in
combination with rituximab, cyclophosphamide, doxorubicin,
vincristine, and prednisone (R-CHOP), demonstrated an overall
response rate (ORR) of 100 percent and a complete response (CR)
rate of 87 percent in high-risk patients (n=46) with previously
untreated DLBCL. Among complete responders, 83 percent remained in
remission after two years. Separately, results from the Phase 2
EPCORE® NHL-1 trial (NCT03625037), evaluating epcoritamab
monotherapy in challenging-to-treat adult patients (n=157) with
relapsed or refractory (R/R) large B-cell lymphoma (LBCL; including
148 patients with R/R DLBCL), showed that among the 41 percent of
patients who achieved a CR, an estimated 52 percent were still
responding at three years (median CR duration: 36.1 months). Both
analyses were presented at the 66th Annual Meeting and Exposition
of the American Society of Hematology (ASH).
“The unprecedented durability of response seen in these data
reinforce the potential of epcoritamab to become a core therapy for
the treatment of multiple B-cell malignancies to benefit more
patients,” said Dr. Judith Klimovsky, Executive Vice President and
Chief Development Officer of Genmab. “These results support our
ongoing Phase 3 trials for epcoritamab, including as an
investigational first-line combination therapy in patients with
previously untreated diffuse large B-cell lymphoma.”
EPCORE® NHL-2 Results in First-Line DLBCL (Abstract
#581)
The EPCORE NHL-2 trial enrolled 46 patients considered to have
high-risk DLBCL, identified by International Prognostic Index (IPI)
scores of 3 to 5, a range associated with poor long-term outcomes.
The IPI is a key tool used by oncologists to predict the prognosis
of aggressive B-cell lymphomas.i At screening, 35 percent of
patients (n=16) had bulky disease (>10 cm) and 21 percent (n=6)
of evaluable patients (n=28) had double-hit/triple-hit LBCL based
on gene rearrangements identified by central analysis.
- With a median follow-up of 27.4 months (range, 0.8-33.9), 87
percent of patients remained alive at two years and 74 percent were
progression free.
- At two years, a minimal residual disease (MRD) analysis showed
MRD negativity was achieved in 91 percent of evaluable patients
(30/33), indicating no detectable disease.
- Epcoritamab in combination with R-CHOP is being studied further
in the ongoing, randomized, Phase 3 EPCORE DLBCL-2 trial
(NCT05578976).
“More first-line treatment options for diffuse large B-cell
lymphoma are needed, especially for patients with aggressive
disease prognostic markers that may impact the efficacy of current
standard first-line therapies,” said Lorenzo Falchi, MD, Lymphoma
Specialist, Department of Medicine, Memorial Sloan Kettering Cancer
Center.ii “Relapse rates with the R-CHOP treatment regimen can
reach 50 percent, so the durable responses observed in the study
suggest significant potential for this first-line epcoritamab-based
combination.”
The most common treatment-emergent adverse events (TEAEs) were
neutropenia (70 percent), anemia (69 percent), cytokine release
syndrome (CRS; 60 percent), fatigue (49 percent), nausea (47
percent), pyrexia (42 percent), and injection-site reaction (40
percent). Four patients (9 percent) discontinued epcoritamab due to
TEAEs; fatal TEAEs occurred in two patients (COVID-19 and septic
shock). CRS events were mostly low grade (45 percent Grade 1, 11
percent Grade 2, 4 percent Grade 3) and mainly occurred after the
first full dose. All CRS cases resolved, and none led to
discontinuation. Immune effector cell-associated neurotoxicity
syndrome (ICANS) occurred in two patients (one Grade 1; one Grade
2) and resolved in a median of 2.5 days without leading to
discontinuation.
Use of epcoritamab + R-CHOP in first-line DLBCL is not approved
in the U.S. or in the EU or in any other territory. The safety and
efficacy of epcoritamab for use as a combination therapy in DLBCL
have not been established.
EPCORE® NHL-1 Results in Third-Line LBCL (Abstract
#4480)
Three-year follow-up results from the Phase 2 EPCORE® NHL-1
trial evaluated epcoritamab monotherapy in 157 patients with R/R
LBCL and demonstrated that epcoritamab continues to deliver durable
responses in challenging-to-treat patients.
- The ORR was 59 percent, and the CR rate was 41 percent. Median
duration of response was 20.8 months (95 percent CI, 13.0-32.0) and
median duration of CR was 36.1 months (95 percent CI, 20.2 to not
reached [NR]).
- 52 percent of patients who experienced a CR were still
responding at three years (median CR duration: 36.1 months).
- Of the 119 patients who were MRD-evaluable, 54 (45 percent)
achieved MRD-negativity. In a cycle 3-day 1 landmark analysis,
3-year PFS rates were 52 percent among MRD-negative patients and 18
percent among MRD-positive patients.
The most common TEAEs were CRS (51 percent; 32 percent Grade 1,
16 percent Grade 2, 3 percent Grade 3), fatigue (25 percent), and
pyrexia (25 percent); CRS rates remained unchanged since prior
reports. Fatal TEAEs were reported in 20 patients; 10 patients had
Grade 5 COVID-19 (including COVID-19 pneumonia). Seventy-three
percent of patients treated with epcoritamab for two or more years
did not experience a Grade 3 or higher infection after two years
(median follow-up after 2 years, 12.3 months). Incidence of Grade 3
or higher cytopenias was highest (27 percent) during the first
eight weeks of treatment and rates were within 0-13 percent in
subsequent 12‑week time periods up to week 144. Immunoglobulin G
levels decreased by a median of approximately 20 percent after the
start of epcoritamab treatment (baseline median, 540.0 mg/dL) and
remained stable over time.
About Diffuse Large B-Cell Lymphoma (DLBCL)
DLBCL is the most common type of non-Hodgkin's lymphoma (NHL)
worldwide, accounting for approximately 25-30 percent of all NHL
cases.iii,iv In the U.S., there are approximately 25,000 new cases
of DLBCL diagnosed each year.v DLBCL can arise in lymph nodes as
well as in organs outside of the lymphatic system, occurs more
commonly in the elderly and is slightly more prevalent in
men.vi,vii DLBCL is a fast-growing type of NHL, a cancer that
develops in the lymphatic system and affects B-cell lymphocytes, a
type of white blood cell. For many people living with DLBCL, their
cancer either relapses, which means it may return after treatment,
or becomes refractory, meaning it does not respond to treatment.
Although new therapies have become available, treatment management
can remain a challenge. viii,ix
About the EPCORE® NHL-2 Trial
EPCORE® NHL-2 is a Phase 1b/2 open-label interventional trial to
evaluate the safety, tolerability, pharmacokinetics,
pharmacodynamics/biomarkers, immunogenicity, and preliminary
efficacy of epcoritamab as a monotherapy and in combination with
other standard of care agents in patients with B-cell non-Hodgkin’s
lymphoma (B-NHL). The trial consists of two parts: Part 1 (Dose
Escalation) and Part 2 (Dose Expansion). The primary objective of
Part 1 is safety, and the primary goal of Part 2 is preliminary
efficacy. The primary endpoint was overall response rate (ORR)
based on best overall response per Lugano criteria. MRD negativity
was assessed as a secondary endpoint.
Arm 1 of the trial is epcoritamab plus rituximab,
cyclophosphamide, doxorubicin, vincristine, and prednisone (R‑CHOP)
in adult patients with previously untreated diffuse large B-cell
lymphoma (DLBCL). More information on this trial can be found at
https://www.clinicaltrials.gov/ (NCT: 04663347).
About the EPCORE® NHL-1 Trial
EPCORE® NHL-1 is an open-label, multicohort, single-arm, Phase
1/2 trial of epcoritamab in participants with relapsed or
refractory large B-cell lymphoma (LBCL), including diffuse large
B-cell lymphoma (DLBCL). The trial was conducted at 88 sites across
15 countries and consisted of three parts: a Phase 1
first-in-human, dose escalation part; a Phase 2a expansion part;
and a Phase 2a dose optimization part. More information on this
trial can be found at https://www.clinicaltrials.gov/ (NCT:
03625037).
About Epcoritamab
Epcoritamab is an IgG1-bispecific antibody created using
Genmab's proprietary DuoBody® technology and administered
subcutaneously. Genmab's DuoBody-CD3 technology is designed to
direct cytotoxic T cells selectively to elicit an immune response
toward target cell types. Epcoritamab is designed to simultaneously
bind to CD3 on T cells and CD20 on B cells and induces
T-cell-mediated killing of CD20+ cells.x
Epcoritamab (approved under the brand name EPKINLY in the U.S.
and Japan, and TEPKINLY in the EU) has received regulatory approval
in certain lymphoma indications in several territories. Epcoritamab
is being co-developed by Genmab and AbbVie as part of the
companies' oncology collaboration. The companies will share
commercial responsibilities in the U.S. and Japan, with AbbVie
responsible for further global commercialization. Both companies
will pursue additional international regulatory approvals for the
investigational R/R FL indication and additional approvals for the
R/R DLBCL indication.
Genmab and AbbVie continue to evaluate the use of epcoritamab as
a monotherapy, and in combination, across lines of therapy in a
range of hematologic malignancies. This includes five ongoing Phase
3, open-label, randomized trials including a trial evaluating
epcoritamab as a monotherapy in patients with R/R DLBCL compared to
investigator’s choice chemotherapy (NCT04628494), a trial
evaluating epcoritamab in combination with R-CHOP in adult patients
with newly diagnosed DLBCL (NCT05578976), a trial evaluating
epcoritamab in combination with rituximab and lenalidomide (R2) in
patients with R/R FL (NCT05409066), a trial evaluating epcoritamab
in combination with rituximab and lenalidomide (R2) compared to
chemoimmunotherapy in patients with previously untreated FL
(NCT06191744), and a trial evaluating epcoritamab in combination
with lenalidomide compared to chemotherapy infusion in patients
with R/R DLBCL (NCT06508658). The safety and efficacy of
epcoritamab has not been established for these investigational
uses. Please visit www.clinicaltrials.gov for more information.
EPKINLY® (epcoritamab-bysp) U.S. INDICATIONS & IMPORTANT
SAFETY INFORMATION
What is EPKINLY?
EPKINLY is a prescription medicine used to treat adults with
certain types of diffuse large B-cell lymphoma (DLBCL), high-grade
B-cell lymphoma, or follicular lymphoma (FL) that has come back or
that did not respond to previous treatment after receiving 2 or
more treatments. EPKINLY is approved based on patient response
data. Studies are ongoing to confirm the clinical benefit of
EPKINLY. It is not known if EPKINLY is safe and effective in
children.
Important Warnings—EPKINLY can cause serious side effects,
including:
- Cytokine release syndrome (CRS), which is common during
treatment with EPKINLY and can be serious or life-threatening. To
help reduce your risk of CRS, you will receive EPKINLY on a step-up
dosing schedule (when you receive 2 or 3 smaller step-up doses of
EPKINLY before your first full dose during your first cycle of
treatment), and you may also receive other medicines before and for
3 days after receiving EPKINLY. If your dose of EPKINLY is delayed
for any reason, you may need to repeat the step-up dosing
schedule.
- Neurologic problems that can be life-threatening and
lead to death. Neurologic problems may happen days or weeks after
you receive EPKINLY.
People with DLBCL or high-grade B-cell lymphoma should be
hospitalized for 24 hours after receiving their first full dose of
EPKINLY on day 15 of cycle 1 due to the risk of CRS and neurologic
problems.
Tell your healthcare provider or get medical help right
away if you develop a fever of 100.4°F (38°C) or higher;
dizziness or lightheadedness; trouble breathing; chills; fast
heartbeat; feeling anxious; headache; confusion; shaking (tremors);
problems with balance and movement, such as trouble walking;
trouble speaking or writing; confusion and disorientation;
drowsiness, tiredness or lack of energy; muscle weakness; seizures;
or memory loss. These may be symptoms of CRS or neurologic
problems. If you have any symptoms that impair consciousness,
do not drive or use heavy machinery or do other dangerous
activities until your symptoms go away.
EPKINLY can cause other serious side effects,
including:
- Infections that may lead to death. Your healthcare
provider will check you for signs and symptoms of infection before
and during treatment and treat you as needed if you develop an
infection. You should receive medicines from your healthcare
provider before you start treatment to help prevent infection. Tell
your healthcare provider right away if you develop any symptoms of
infection during treatment, including fever of 100.4°F (38°C) or
higher, cough, chest pain, tiredness, shortness of breath, painful
rash, sore throat, pain during urination, or feeling weak or
generally unwell.
- Low blood cell counts, which can be serious or severe.
Your healthcare provider will check your blood cell counts during
treatment. EPKINLY may cause low blood cell counts, including low
white blood cells (neutropenia), which can increase your risk for
infection; low red blood cells (anemia), which can cause tiredness
and shortness of breath; and low platelets (thrombocytopenia),
which can cause bruising or bleeding problems.
Your healthcare provider will monitor you for symptoms of CRS,
neurologic problems, infections, and low blood cell counts during
treatment with EPKINLY. Your healthcare provider may temporarily
stop or completely stop treatment with EPKINLY if you develop
certain side effects.
Before you receive EPKINLY, tell your healthcare provider
about all your medical conditions, including if you have an
infection, are pregnant or plan to become pregnant, or are
breastfeeding or plan to breastfeed. If you receive EPKINLY while
pregnant, it may harm your unborn baby. If you are a female who
can become pregnant, your healthcare provider should do a
pregnancy test before you start treatment with EPKINLY and you
should use effective birth control (contraception) during treatment
and for 4 months after your last dose of EPKINLY. Tell your
healthcare provider if you become pregnant or think that you may be
pregnant during treatment with EPKINLY. Do not breastfeed during
treatment with EPKINLY and for 4 months after your last dose of
EPKINLY.
In DLBCL or high-grade B-cell lymphoma, the most common side
effects of EPKINLY include CRS, tiredness, muscle and bone
pain, injection site reactions, fever, stomach-area (abdominal)
pain, nausea, and diarrhea. The most common severe abnormal
laboratory test results include decreased white blood cells,
decreased red blood cells, and decreased platelets.
In follicular lymphoma the most common side effects of
EPKINLY include injection site reactions, CRS, COVID-19,
tiredness, upper respiratory tract infections, muscle and bone
pain, rash, diarrhea, fever, cough, and headache. The most
common severe abnormal laboratory test results include
decreased white blood cells and decreased red blood cells.
These are not all of the possible side effects of EPKINLY. Call
your doctor for medical advice about side effects. You are
encouraged to report side effects to the FDA at (800) FDA-1088 or
www.fda.gov/medwatch or to Genmab US, Inc. at 1-855-4GENMAB
(1-855-443-6622).
Please see Full Prescribing Information and Medication
Guide, including Important Warnings.
Globally, prescribing information varies; refer to the
individual country product label for complete information.
About Genmab
Genmab is an international biotechnology company with a core
purpose of guiding its unstoppable team to strive toward improving
the lives of patients with innovative and differentiated antibody
therapeutics. For 25 years, its passionate, innovative and
collaborative team has invented next-generation antibody technology
platforms and leveraged translational, quantitative and data
sciences, resulting in a proprietary pipeline including bispecific
T-cell engagers, antibody-drug conjugates, next-generation immune
checkpoint modulators and effector function-enhanced antibodies. By
2030, Genmab’s vision is to transform the lives of people with
cancer and other serious diseases with knock-your-socks-off (KYSO®)
antibody medicines.
Established in 1999, Genmab is headquartered in Copenhagen,
Denmark, with international presence across North America, Europe
and Asia Pacific. For more information, please visit Genmab.com and
follow us on LinkedIn and X.
This Media Release contains forward looking statements. The
words “believe,” “expect,” “anticipate,” “intend” and “plan” and
similar expressions identify forward looking statements. Actual
results or performance may differ materially from any future
results or performance expressed or implied by such statements. The
important factors that could cause our actual results or
performance to differ materially include, among others, risks
associated with preclinical and clinical development of products,
uncertainties related to the outcome and conduct of clinical trials
including unforeseen safety issues, uncertainties related to
product manufacturing, the lack of market acceptance of our
products, our inability to manage growth, the competitive
environment in relation to our business area and markets, our
inability to attract and retain suitably qualified personnel, the
unenforceability or lack of protection of our patents and
proprietary rights, our relationships with affiliated entities,
changes and developments in technology which may render our
products or technologies obsolete, and other factors. For a further
discussion of these risks, please refer to the risk management
sections in Genmab’s most recent financial reports, which are
available on www.genmab.com and the risk factors included in
Genmab’s most recent Annual Report on Form 20-F and other filings
with the U.S. Securities and Exchange Commission (SEC), which are
available at www.sec.gov. Genmab does not undertake any obligation
to update or revise forward looking statements in this Media
Release nor to confirm such statements to reflect subsequent events
or circumstances after the date made or in relation to actual
results, unless required by law.
Genmab A/S and/or its subsidiaries own the following trademarks:
Genmab®; the Y-shaped Genmab logo®; Genmab in combination with the
Y-shaped Genmab logo®; HuMax®; DuoBody®; HexaBody®; DuoHexaBody®,
HexElect® and KYSO™. EPCORE®, EPKINLY®, TEPKINLY® and their designs
are trademarks of AbbVie Biotechnology Ltd.
i Maurer M. The International Prognostic Index in aggressive
B-cell lymphoma. Haematologica. 2023 Nov 1;108(11):2874–2879. doi:
10.3324/haematol.2023.284070 ii Dr. Falchi has financial interests
related to Genmab and AbbVie. iii Lymphoma Research Foundation.
Diffuse Large B-Cell Lymphoma. Accessed November 2024.
https://lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/dlbcl/
iv Padala, et al. Diffuse Large B-Cell Lymphoma. StatPearls
[Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
2023 Apr 24. v Leukemia and Lymphoma Society. Diffuse Large B-Cell
Lymphoma (DLBCL). Accessed November 2024.
https://www.lls.org/research/diffuse-large-b-cell-lymphoma-dlbcl vi
Sehn, et al. Diffuse Large B-Cell Lymphoma. N Engl J Med.
2021;384:842-858. doi: 10.1056/NEJMra2027612. vii Kanas, et al.
Epidemiology of Diffuse Large B-Cell Lymphoma (DLBCL) and
Follicular Lymphoma (FL) in the United States and Western Europe:
Population-Level Projections for 2020-2025. Leuk Lymphoma.
2022;63(1):54-63. doi: 10.1080/10428194.2021.1975188. viii Sehn LH,
Salles G. Diffuse Large B-Cell Lymphoma. N Engl J Med.
2021;384:842-858. DOI: 10.1056/NEJMra2027612. ix Crump, et al.
Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results From
the International SCHOLAR-1 Study. Blood. 2017;130(16):1800-1808.
doi: 10.1182/blood-2017-03-769620. x Engelberts PJ, Hiemstra IH, de
Jong B, et al. DuoBody-CD3xCD20 induces potent T-cell-mediated
killing of malignant B cells in preclinical models and provides
opportunities for subcutaneous dosing. EBioMedicine.
2020;52:102625. DOI: 10.1016/j.ebiom.2019.102625.
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