epcoritamab: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
epcoritamab: clinical details
Prescribing considerations
- Administration requires supervision by a clinician experienced in anticancer therapy, with immediate support available for severe cytokine release syndrome and neurological toxicity.
- Assess infection status and tumour lysis risk before treatment; consider hydration, urate-lowering measures and locally appropriate antimicrobial prophylaxis.
- Provide the patient card and counsel patients and carers about cytokine release syndrome, ICANS and delayed neurological symptoms.
- Record the product name and batch number for biological traceability.
- Evidence is limited in moderate hepatic impairment and unavailable in severe hepatic or severe renal impairment.
Contraindications and cautions
- Hypersensitivity to epcoritamab or any excipient.
- Withhold during active infection until resolved.
- Use particular caution with previous neurological disease, high tumour burden, reduced renal function, impaired immunity or tumours close to airways or vital organs.
Monitoring
- Monitor for cytokine release syndrome, ICANS, HLH, infection, tumour lysis and tumour flare.
- Full blood count, including neutrophils and platelets.
- Immunoglobulin levels before and during treatment.
- Renal function, electrolytes, urate and other blood chemistry where tumour lysis is a concern.
- Assess neurological symptoms; investigate possible PML and discontinue epcoritamab if suspected.
Clinical pharmacology
A humanised IgG1 bispecific antibody targeting CD20 and CD3. It activates endogenous T cells against CD20-expressing cells, undergoes target-mediated clearance and is expected to be broken down into peptides and amino acids.
Formulation and product differences
- Ready-to-use, single-use solution for subcutaneous injection that does not require dilution.
- The solution should be colourless to slightly yellow; do not use it if cloudy, discoloured or containing particles.
- Contains sorbitol and polysorbate 80; polysorbates may cause allergic reactions.
epcoritamab preparations and strengths
Injection
Route: Parenteral
Strengths: 4 mg/0.8 mL, 48 mg
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.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.