Epcoritamab (CD3×CD20 bispecific) delivers 57.6% CR as chemo-free 1L option in anthracycline-ineligible DLBCL

Epcoritamab is a subcutaneous CD3×CD20 T-cell–engaging bispecific antibody evaluated as fixed-duration first-line therapy (± lenalidomide) in the open-label randomized Phase 2 EPCORE DLBCL-3 trial (NCT05660967) for newly diagnosed CD20+ large B-cell lymphoma patients ineligible for anthracycline chemoimmunotherapy (≥80y, or ≥75y with significant comorbidities; stage II–IV; ECOG 0–2). In stage 1, CR rate was 63.6% with epcoritamab monotherapy (28/44) vs 45.5% with epcoritamab+lenalidomide (20/44) at the Dec 5, 2025 cutoff; across stages 1+2, epcoritamab monotherapy achieved a 57.6% CR rate (38/66), which sits within the published CR range reported for attenuated anthracycline regimens in very elderly patients (e.g., R-mini-CHOP CR ≈34% in a large prospective cohort, with other series showing ~37%–67%). Grade ≥3 TEAEs differed materially: infections 18% and fatigue 14% with monotherapy vs neutropenia 40% and infections 38% with the lenalidomide combo; treatment-emergent deaths were 14% in each stage-1 arm, with stage-2 monotherapy reporting 2 additional deaths (3%).