epcoritamab at a glance
Medicine class
CD3×CD20 bispecific antibody
Main uses
Previously treated diffuse large B-cell lymphoma and follicular lymphoma in adults
Administration
Subcutaneous injection given by a cancer specialist or trained healthcare professional
Important risks
Cytokine release syndrome, neurological toxicity and serious infection
What is epcoritamab used for?
Licensed uses in adults are:
On its own for relapsed or refractory diffuse large B-cell lymphoma after two or more previous systemic treatment lines.
On its own for relapsed or refractory follicular lymphoma after two or more previous systemic treatment lines.
With lenalidomide and rituximab for relapsed or refractory follicular lymphoma after at least one previous systemic treatment line.
How does epcoritamab work?
Epcoritamab binds CD20 on B cells and CD3 on T cells. Bringing lymphoma cells and T cells together activates T-cell-mediated killing of CD20-expressing cells.
epcoritamab preparations and strengths
Injection
Route: Parenteral
Strengths: 4 mg/0.8 mL, 48 mg
How to take epcoritamab
A healthcare professional prepares and injects epcoritamab under the skin, usually into the lower abdomen or thigh. Injection sides should be alternated. Medicines and fluids may be given around treatment to reduce cytokine release syndrome and tumour lysis risks.
Do not inject or prepare epcoritamab yourself.
Follow hydration instructions from the treatment team.
Carry the patient card at all times.
Do not stop treatment without discussing it with the oncology team.
epcoritamab side effects
Common or expected effects
- Injection-site redness, swelling, pain or itching
- Tiredness and fever
- Viral or respiratory infections
- Muscle, bone or joint pain
- Diarrhoea, nausea or abdominal pain
- Headache, rash or swelling
- Reduced neutrophils, red cells, platelets, lymphocytes or immunoglobulins
Get urgent medical advice
- Cytokine release syndrome: fever, chills, dizziness, fast heartbeat, low blood pressure or breathing difficulty
- Neurological toxicity or ICANS: confusion, drowsiness, speech or writing difficulty, weakness, seizures or memory loss
- Serious infection, including fever with reduced neutrophils, pneumonia or sepsis
- Tumour lysis syndrome, which may cause confusion, abnormal heartbeat, dark urine, marked tiredness or seizures
- Haemophagocytic lymphohistiocytosis: persistent fever with rash, swollen glands, breathing problems or easy bruising
- Progressive neurological changes that could indicate progressive multifocal leukoencephalopathy
epcoritamab in pregnancy
Epcoritamab is not recommended during pregnancy because its mechanism could harm the fetus, and pregnancy data are unavailable. Pregnancy status should be checked before treatment; effective contraception is advised during treatment and for at least four months afterwards. Discuss pregnancy or pregnancy plans promptly with the specialist team.
epcoritamab while breastfeeding
It is unknown whether epcoritamab passes into human milk, although antibody transfer is possible. Breastfeeding should stop during treatment and for at least four months afterwards. Seek specialist advice when planning feeding.
epcoritamab interactions
Formal interaction studies have not been performed. Tell the oncology team about prescription, non-prescription and herbal products.
Live or live-attenuated vaccines
These should not be given during treatment because safety has not been established and immune responses may be impaired.
Narrow-therapeutic-index CYP450 substrates
Cytokine changes when epcoritamab is started may alter their metabolism, so therapeutic monitoring should be considered.
Blood-pressure-lowering medicines
The treatment team may temporarily adjust these because cytokine release syndrome can cause low blood pressure.
Common questions about epcoritamab
Answers are fully visible for fast scanning and source review.
What cancers is epcoritamab licensed to treat?
Specified previously treated relapsed or refractory diffuse large B-cell lymphoma or follicular lymphoma in adults. For follicular lymphoma, it may be used alone or with lenalidomide and rituximab, depending on previous treatment.
Is epcoritamab chemotherapy?
No. It is a bispecific antibody immunotherapy that redirects T cells towards CD20-expressing lymphoma cells.
How is epcoritamab given?
A trained healthcare professional injects it under the skin, generally in the lower abdomen or thigh.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.