Abstract
Glofitamab and epcoritamab are CD3xCD20 bispecific antibodies licensed for relapsed/refractory large B cell lymphoma (RR LBCL), yet real-world data are limited. Data were collected from 332 patients (219 glofitamab, 113 epcoritamab) across 34 UK centres (November 2023-May 2025). This high-risk cohort had median 2 prior lines of treatment; 179 (55%) primary refractory disease; 81 (25%) ECOG ≥2; 152 (50%) prior Chimeric Antigen Receptor T-cell therapy; and 232 (78%) pivotal-trial ineligible. 7 patients died before treatment initiation, 1 patient was yet to start treatment, of 324 treated patients, 28% had cytokine release syndrome (CRS), predominately grade 1/2 (82/90). Overall response rate (ORR) and complete response rate (CRR) were 43% and 24%, respectively, while for trialeligible patients the CRR was 43%. At a median 10.0 months follow-up (IQR 5.3-15.0), median progression-free survival (PFS) was 3.1 months (95% confidence interval [CI], 2.5-4.2), median overall survival (OS) was 6.9 months (95% CI, 4.9-10.8). For patients not completing cycle 2, 6-month OS was 4% (95% CI 1-11%). Median duration of complete response was not reached. Refractoriness to prior line of treatment (HR 2.89, 95% CI 1.73-4.81, p=0.007), elevated LDH (HR 2.62, 95% CI 1.74-3.93. p=0.001), bendamustine exposure within 6 months (HR 1.62, 95% CI 1.14-2.30, p=0.007) and ECOG 1 (HR 2.70, 95% CI 1.52-4.79, p=0.001) or 2 (HR 6.49, 95% CI 3.47-12.01, p<0.001) were associated with inferior PFS. This analysis shows both glofitamab and epcoritamab are effective treatment options in RR LBCL with durable complete responses achieved while underscoring the importance of improved patient selection.
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