# EPCORE NHL-1: epcoritamab, a subcutaneous CD20 x CD3 bispecific, in relapsed large B-cell lymphoma including after CAR-T

Source: https://onco.cc/key-papers/paper-epcore-nhl-1-epcoritamab-jco-2023/  
OnCo record `paper-epcore-nhl-1-epcoritamab-jco-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In EPCORE NHL-1, the off-the-shelf bispecific antibody epcoritamab, injected under the skin, produced responses in 63% of 157 patients with relapsed large B-cell lymphoma, including the 39% whose CAR-T had failed. Cytokine release syndrome occurred in half, mostly mild, and the drug won accelerated approval in 2023.

## Summary

The dose-expansion part of EPCORE NHL-1 treated 157 patients with relapsed or refractory large B-cell lymphoma after at least two prior lines (median three; 39% had prior CAR-T) with subcutaneous epcoritamab given with step-up dosing then weekly, fortnightly and monthly. The overall response rate was 63.1% with complete response in 38.9%; median duration of response was 12.0 months and complete responders had durable remissions. CRS occurred in 49.7% (grade 3 in 2.5%) and ICANS in 6.4% with one fatal event. Responses were similar after CAR-T failure. Epcoritamab received accelerated approval in 2023, alongside the intravenous CD20 x CD3 bispecific glofitamab, whose pivotal study reported complete response in 39% of 155 patients.

## Fields

- Kind: Key paper
- Last checked: 2026-09-08
- Journal: Journal of Clinical Oncology
- Year: 2023
- DOI: 10.1200/JCO.22.01725
- Authors: Thieblemont C, Phillips T, Ghesquieres H, et al.
- Findings: 157 patients with relapsed/refractory LBCL after 2 or more lines; 38.9% had prior CAR-T.; Overall response 63.1%; complete response 38.9%.; Median duration of response 12.0 months; most complete responses ongoing at data cut.; CRS 49.7% (grade 3 2.5%), largely confined to cycle 1; ICANS 6.4% (one fatal).; Similar response rates in patients whose CAR-T had failed.
- What it means: CD20 x CD3 bispecifics gave patients whose lymphoma has failed CAR-T, or who cannot access it, an effective off-the-shelf treatment that can be started within days. Epcoritamab and glofitamab are now standard third-line options and are moving into earlier lines and combinations. They do not yet replace CAR-T, whose remissions appear more durable.
- Caveats: Single-arm phase 2; randomised confirmation in earlier lines came later with mixed results in some designs.; Fixed-duration (glofitamab) versus until-progression (epcoritamab) dosing remains a practical difference without head-to-head data.; Infection risk and hypogammaglobulinaemia accumulate with prolonged dosing.; Durability of partial responses is limited.

## Sources

- PubMed search: https://pubmed.ncbi.nlm.nih.gov/?term=EPCORE%20NHL-1%20epcoritamab%20large%20B-cell%20lymphoma%20Thieblemont%20JCO%202023
- ClinicalTrials.gov NCT03625037: https://clinicaltrials.gov/study/NCT03625037

## Connected records

- pairings: [CD20 bispecific + CD79b ADC (mosunetuzumab + polatuzumab)](https://onco.cc/pairings/bispecific-plus-adc-lymphoma/)
- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/)
- technologies: [Bispecific antibodies](https://onco.cc/technologies/bispecific-antibody/), [T-cell engagers (bispecific)](https://onco.cc/technologies/t-cell-engager/)
- targets: [CD20](https://onco.cc/targets/cd20/), [CD3](https://onco.cc/targets/cd3/)
- drugs: [Epcoritamab](https://onco.cc/drugs/epcoritamab/), [Glofitamab](https://onco.cc/drugs/glofitamab/), [Mosunetuzumab](https://onco.cc/drugs/mosunetuzumab/), [Odronextamab](https://onco.cc/drugs/odronextamab/)
- companies: [AbbVie (incl. ImmunoGen, Capstan)](https://onco.cc/companies/abbvie/), [Roche / Genentech](https://onco.cc/companies/roche-genentech/)
- terms: [Cytokine release syndrome (CRS)](https://onco.cc/terms/crs/), [ICANS (neurotoxicity)](https://onco.cc/terms/icans/), [Objective response rate (ORR)](https://onco.cc/terms/orr/)
- trials: [EPCORE DLBCL-1](https://onco.cc/trials/epcore-dlbcl-1/), [EPCORE NHL-1](https://onco.cc/trials/epcore-nhl-1/), [STARGLO](https://onco.cc/trials/starglo/)
- bottlenecks: [Acquired resistance to every therapy](https://onco.cc/bottlenecks/b-resistance/), [Manufacturing cost and time for living and radioactive medicines](https://onco.cc/bottlenecks/b-manufacturing-cell-therapy/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)
- people: [Catherine Thieblemont](https://onco.cc/people/catherine-thieblemont/)

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