
27 Jan Combining Chemotherapy with Immunotherapy Tackles Hard to Treat Lymphoma
MedicalResearch.com Interview with:

Dr. Brody
Joshua Brody MD
Director, Lymphoma Immunotherapy Program
Icahn School of Medicine at Mount Sinai
Hess Center for Science and Medicine
New York, New York 10029
MedicalResearch.com: What is the background for this study?
- Patients with relapsed diffuse large B-cell lymphoma (DLBCL) have poor outcomes.
- Standard chemotherapy e.g. Gemcitabine + Oxaliplatin (GemOx) yields complete response in ~30% of these patients.
- Epcoritamab, a CD3xCD20 bispecific antibody immunotherapy was recently approved for relapsed DLBCL as monotherapy but is not yet approved as part of combination therapy.
- Other immunotherapies e.g. CAR-T have been difficult to combine with standard therapies.
MedicalResearch.com: What are the main findings?
- 103 relapsed DLBCL patients were treated with Epcoritamab + GemOx
- The cohort was of advanced age (median 72 years old) and with high-risk disease – the majority had primary refractory disease and were refractory to the most recent therapy -~half of patients experienced Cytokine Release Syndrome (CRS) but nearly all of these (>95%) were low-grade
- Beyond CRS, the safety profile was similar to that of standard GemOx therapy
- Complete remission was achieved in 61% of patients
- Complete remissions were long-lasting, median ~24 months
- A similar immunotherapy/chemotherapy combination was tested in another recent (randomized) study -STARGLO- demonstrating similarly impressive results.
MedicalResearch.com: What other types of lymphoma/cancers might be amenable to this approach?
Response: Likely, all B-cell lymphomas (follicular, mantle cell, marginal zone etc) would be similarly benefited by combinations of chemotherapy and bispecific antibodies.
Possibly, other cancers with FDA approved bispecific antibodies (subsets of lung cancer, myeloma and leukemia) would also benefit from combinations of these immunotherapies with standard chemotherapies.
MedicalResearch.com: What should readers take away from your report?
Response: Patients with relapsed diffuse large B-cell lymphoma should likely not be receiving chemotherapy alone, but rather some type of immunotherapy (CAR-T or bispecific antibodies) or a combination of chemotherapy and immunotherapy.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: The future is already here, follow-up randomized trials testing bispecific antibodies in combination with frontline chemotherapy are nearing completion and will likely become the new standard-of-care within the next few years.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: Bispecific antibodies have rapidly become the favorite new class of therapies amongst lymphoma specialists, though their uptake amongst community oncologists has been slower. One reason is because the required ~24-hour hospitalization/observation recommended for some bispecifics is logistically difficult.
There are a few take-homes here:
- The lymphoma bispecifics FDA-approved for low-grade lymphomas do not require hospitalization for most patients.
- Because bispecifics will almost certainly become part of frontline DLBCL therapy within a few years (combined with chemo), some savvy community oncologists are already starting to solve the hospitalization hurdles.
- One solution being developed is short-term observation centers (analogous to Chest Pain Centers which proliferated to address similar observational needs).
- Another approach used successfully by some community oncologists has been to ‘share’ the patients, having the first cycle of therapy given with a lymphoma specialist, and then returned to the community for subsequent cycles.
Disclosures: Dr. Brody receives research funding from:
-ADC Therapeutics, Astrazeneca, BMS, Epizyme, Genmab, Kite/Gilead, Merck, Roche, and Seagen.
Citation:
Brody JD, Jørgensen JM Dr, Belada D, Costello R, Trněný M, Vitolo U, Lewis DJ, Karimi YH, Sureda A, Andre M, Wahlin BE, Lugtenburg PJ, Jiang T, Karagoz K, Steele AJ, Abbas A, Wang L, Risum M, Cordoba R. Epcoritamab plus GemOx in transplant-ineligible relapsed/refractory DLBCL: results from the EPCORE NHL-2 trial. Blood. 2025 Jan 10:blood.2024026830. doi: 10.1182/blood.2024026830. Epub ahead of print. PMID: 39792928.
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Last Updated on January 27, 2025 by Marie Benz MD FAAD