Phase 2 epcoritamab CD3×CD20 bispecific T‑cell engager vs watchful waiting in low‑burden FL.

This randomized Phase 2 study at MD Anderson Cancer Center tests whether starting epcoritamab earlier can delay the need for conventional lymphoma therapy in previously untreated, low tumor burden follicular lymphoma (stage II–IV, grade 1–3a). Patients are assigned to epcoritamab (a subcutaneous CD3×CD20 bispecific antibody that redirects T cells to kill CD20+ B‑cells) versus observation/watch-and-wait with no anti-lymphoma intervention. The primary goal is time to next treatment—how long patients can go before needing new lymphoma-directed systemic therapy. While MD Anderson sponsors the trial, epcoritamab was developed by Genmab and AbbVie, and this study explores whether a T‑cell–engaging immunotherapy can safely “pull forward” active treatment in a population often managed conservatively. Today, many low-tumor-burden FL patients are observed until symptoms or progression, then treated with anti‑CD20–based therapy (rituximab alone or chemoimmunotherapy such as bendamustine‑rituximab) or newer options depending on disease course.