- Data from the pivotal phase 1/2 EPCORE™ NHL-1 study showed
82 percent overall response rate (ORR), 63 percent complete
response (CR) and 67 percent minimal residual disease (MRD)
negativity in patients with relapsed/refractory (R/R) follicular
lymphoma (FL) treated with subcutaneous epcoritamab
- Results presented at the 65th American Society of Hematology
(ASH) Annual Meeting and Exposition include data from an optimized
step-up dosing schedule for FL patients showing meaningful
reduction in risk and severity of cytokine release syndrome
(CRS)
- Follicular lymphoma is the second most common form of
non-Hodgkin’s lymphoma, is considered incurable and can be
difficult to treat in the R/R setting
Genmab A/S (Nasdaq: GMAB) and AbbVie (NYSE: ABBV)
today announced new data from the ongoing phase 1/2 EPCORE™
NHL-1 clinical trial investigating epcoritamab (DuoBody® CD3xCD20),
a T-cell engaging bispecific antibody administered
subcutaneously, demonstrated an overall response rate (ORR) of
82 percent, a complete response (CR) rate of 63 percent and minimal
residual disease (MRD) negativity rate of 67 percent in patients
with relapsed/refractory (R/R) follicular lymphoma (FL). The
presentation included data from an optimized step-up dosing
schedule for FL patients showing a reduction in risk and severity
of Grade 2+ cytokine release syndrome (CRS), a common side effect
of T-cell engaging cancer treatments. These results were presented
today at the 2023 65th Annual Meeting and Exposition of the
American Society of Hematology (ASH), being held in San Diego,
California, December 9-12, 2023 (Abstract #1655).
“Despite treatment advances for patients with follicular
lymphoma whose disease has unfortunately progressed, treating
relapsed or refractory follicular lymphoma remains highly
challenging, particularly in the third-line plus setting,” said
Catherine Thieblemont, M.D., Ph.D., head of the hemato-oncology
department, Paris University, Hôpital Saint-Louis
Assistance-Publique-Hopitaux de Paris (APHP) in Paris. “The
patients in this trial represent a historically difficult-to-treat
patient population. The data presented today are especially notable
because they demonstrated high overall and complete response rates
for this investigational follicular lymphoma therapy and a preview
for its potential as an alternative treatment option.”
Overall results from the pivotal cohort of 128 adult patients
showed that:
- At a median follow-up of 17.4 months, the study’s primary
endpoint ORR was 82 percent, which exceeded the protocol defined
threshold for efficacy, with a CR rate of 63 percent, and 67
percent MRD negativity.
- The median time to response was 1.4 months and median time to
CR was 1.5 months.
- Median progression-free survival (PFS) for patients who
achieved a CR was not reached nor was the median duration of
response, duration of CR, MRD negativity and overall survival.
- An estimated 85 percent and 74 percent of patients who
experienced a CR remained in response at 12 and 18 months,
respectively.
Among prespecified subgroups, ORR and CR rates were generally
consistent with the overall patient population. Notably, high-risk
patients who were refractory to both anti-CD20 therapy and an
alkylating agent achieved a 76 percent ORR and 56 percent CR;
patients who were refractory to last prior treatment achieved a 74
percent ORR and 51 percent CR rate; and patients whose disease
progressed within two years of first-line immunochemotherapy
(POD24) achieved an 80 percent ORR and 61 percent CR.
Safety findings were consistent with previous epcoritamab
trials, and epcoritamab was generally well tolerated. Following an
optimized step-up dose regimen for FL patients (n=50) to reduce the
risk and severity of CRS, 40 percent of patients experienced Grade
1 CRS and 8 percent experienced Grade 2 (no Grade 3 or higher CRS
were reported) and no Immune Effector Cell-Associated Neurotoxicity
Syndrome (ICANS) was reported. This data may support outpatient
administration. Additional common treatment-emergent adverse events
(TEAEs) from the pivotal cohort (>20 percent) were
injection-site reaction (57 percent), COVID-19 (40 percent),
fatigue (30 percent), neutropenia (29 percent), diarrhea (27
percent) and pyrexia (25 percent). TEAEs leading to treatment
discontinuation occurred in 19 percent of patients, and Grade 5
TEAEs occurred in 13 patients (10 percent).
“Follicular lymphoma patients who have experienced a relapse
following heavy pre-treatment, or whose disease is not responding
to available therapies, are considered high risk and are in need of
alternative therapeutic options,” said Jan van de Winkel, Ph.D.,
Chief Executive Officer of Genmab. “The data presented at ASH
reinforce what we have seen from our epcoritamab research and
believe that this investigational bispecific antibody could
potentially represent an important treatment option for patients
living with relapsed or refractory follicular lymphoma. Along with
our partner AbbVie, we look forward to progressing epcoritamab in
clinical trials and discussing the results with regulatory
authorities and remain committed to developing epcoritamab as a
potential future core therapy for B-cell malignancies.”
About the Phase 1/2 EPCORE™ NHL-1 Trial EPCORE™ NHL-1 an
open-label, multi-center safety and preliminary efficacy trial of
epcoritamab that consists of three parts: a phase 1 first-in-human,
dose escalation part; a phase 2a expansion part; and a phase 2a
dose optimization part. The trial was designed to evaluate
subcutaneous epcoritamab in patients with relapsed, progressive or
refractory CD20+ mature B-cell non-Hodgkin’s lymphoma (B-NHL),
including FL. In the phase 2a expansion part, additional patients
were enrolled to further explore the safety and efficacy of
epcoritamab in three cohorts of patients with different types of
relapsed/refractory B-NHLs who have limited therapeutic options.
The dose optimization part evaluates the potential for alternative
step-up dosing regimens to help further minimize Grade 2 cytokine
release syndrome (CRS) and mitigate Grade ≥3 CRS. The primary
endpoint of the expansion part was ORR as assessed by an IRC.
Secondary efficacy endpoints included DOR, complete response rate,
duration of complete response, progression-free survival, and time
to response as determined by the Lugano criteria. Overall survival,
time to next therapy, and rate of minimal residual disease
negativity were also evaluated as secondary efficacy endpoints.
About Follicular Lymphoma (FL) FL is typically an
indolent (or slow growing) form of non-Hodgkin’s lymphoma (NHL)
that arises from B-lymphocytes.i FL is the second most common form
of NHL overall, accounting for 20-30 percent of all NHL cases, and
represents 10-20 percent of all lymphomas in the western
world.i,ii,iii Although FL is an indolent lymphoma, it is
considered incurable with conventional therapyiv,v and patients who
achieve remission also often experience relapse.vi
About Epcoritamab Epcoritamab is an IgG1-bispecific
antibody created using Genmab's proprietary DuoBody® technology and
administered subcutaneously. Genmab's DuoBody-CD3 technology is
designed to direct cytotoxic T cells selectively to elicit an
immune response toward target cell types. Epcoritamab is designed
to simultaneously bind to CD3 on T cells and CD20 on B cells and
induces T-cell-mediated killing of CD20+ cells.vii
Epcoritamab (approved under the brand name EPKINLY® in the U.S.
and Japan, and TEPKINLY® in the EU) has received regulatory
approval in certain lymphoma indications in several territories.
Use of epcoritamab in FL is not approved in any country, including
the U.S. and the EU. Epcoritamab is being co-developed by Genmab
and AbbVie as part of the companies' oncology collaboration. The
companies will share commercial responsibilities in the U.S. and
Japan, with AbbVie responsible for further global
commercialization.
Genmab and AbbVie continue to evaluate the use of epcoritamab as
a monotherapy, and in combination, across lines of therapy in a
range of hematologic malignancies. This includes three ongoing
phase 3, open-label, randomized trials including a trial evaluating
epcoritamab as a monotherapy in patients with R/R DLBCL (NCT:
04628494) compared to investigators choice chemotherapy, a phase 3
trial evaluating epcoritamab in combination with R-CHOP in adult
participants with newly diagnosed DLBCL (NCT: 05578976), and a
phase 3, open-label clinical trial evaluating epcoritamab in
combination with rituximab and lenalidomide in patients with R/R FL
(NCT: 05409066). Epcoritamab is not approved to treat newly
diagnosed patients with DLBCL or FL. The safety and efficacy of
epcoritamab has not been established for these investigational
uses. Please visit clinicaltrials.gov for more information.
EPKINLY® (epcoritamab-bysp) U.S. IMPORTANT SAFETY
INFORMATION
Use
EPKINLY is a prescription medicine used in the U.S. to treat
adults with certain types of diffuse large B-cell lymphoma (DLBCL)
and high-grade B-cell lymphoma that has come back (relapsed) or
that did not respond to previous treatment (refractory), and who
have received 2 or more treatments for their cancer.
EPKINLY is approved based on patient response data. A study
is ongoing to confirm the clinical benefit of EPKINLY. It is not
known if EPKINLY is safe and effective in children.
Important Warnings—EPKINLY can cause serious side effects,
including:
- Cytokine release syndrome (CRS), which is common during
treatment with EPKINLY and can be serious or life-threatening. To
help reduce your risk of CRS, you may receive other medicines
before receiving EPKINLY and you will also be given smaller doses
of EPKINLY for the first 2 doses (called “step-up” dosing). Your
first full dose of EPKINLY will be given on day 15 of your first
cycle of treatment and you should be hospitalized for 24 hours
after due to risk of CRS and neurologic problems. If your dose of
EPKINLY is delayed for any reason, you may need to repeat the
step-up dosing schedule.
- Neurologic problems that can be life-threatening and
lead to death. Neurologic problems may happen days or weeks after
you receive EPKINLY.
Tell your healthcare provider or get medical help right
away if you develop a fever of 100.4°F (38°C) or higher;
dizziness or lightheadedness; trouble breathing; chills; fast
heartbeat; feeling anxious; headache; confusion; shaking (tremors);
problems with balance and movement, such as trouble walking;
trouble speaking or writing; confusion and disorientation;
drowsiness, tiredness or lack of energy; muscle weakness; seizures;
or memory loss. These may be symptoms of CRS or neurologic
problems. Do not drive or use heavy machinery or do
other dangerous activities if you have any symptoms that impair
consciousness until your symptoms go away.
EPKINLY can cause other serious side effects,
including:
- Infections that may lead to death. Tell your healthcare
provider right away if you develop any symptoms of infection during
treatment, including fever of 100.4°F (38°C) or higher, cough,
chest pain, tiredness, shortness of breath, painful rash, sore
throat, pain during urination, or feeling weak or generally
unwell.
- Low blood cell counts are common during treatment with
EPKINLY and can be serious or severe. Your healthcare provider will
check your blood cell counts during treatment. EPKINLY may cause
low blood cell counts, including low white blood cells
(neutropenia), which can increase your risk for infection; low red
blood cells (anemia), which can cause tiredness and shortness of
breath; and low platelets (thrombocytopenia), which can cause
bruising or bleeding problems.
Your healthcare provider will monitor you for symptoms of CRS,
neurologic problems, infections, and low blood cell counts during
treatment with EPKINLY. Your healthcare provider may temporarily
stop or completely stop treatment with EPKINLY if you develop
certain side effects.
Before you receive EPKINLY, tell your healthcare provider
about all your medical conditions, including if you have an
infection, are pregnant or plan to become pregnant, or are
breastfeeding or plan to breastfeed. If you receive EPKINLY while
pregnant, it may harm your unborn baby. If you are a female who
can become pregnant, your healthcare provider should do a
pregnancy test before you start treatment with EPKINLY and you
should use effective birth control (contraception) during treatment
and for 4 months after your last dose of EPKINLY. Tell your
healthcare provider if you become pregnant or think that you may be
pregnant during treatment with EPKINLY. Do not breastfeed during
treatment with EPKINLY and for 4 months after your last dose of
EPKINLY.
The most common side effects of EPKINLY include CRS,
tiredness, muscle and bone pain, injection site reactions, fever,
stomach-area (abdominal) pain, nausea, and diarrhea. These are not
all the possible side effects of EPKINLY. Call your doctor for
medical advice about side effects.
You are encouraged to report side effects to the FDA at (800)
FDA-1088 or www.fda.gov/medwatch or to Genmab US, Inc. at
1-855-4GENMAB (1-855-443-6622).
Please see the Full Prescribing Information and Medication
Guide, including Important Warnings.
About Genmab Genmab is an international biotechnology
company with a core purpose guiding its unstoppable team to strive
towards improving the lives of patients through innovative and
differentiated antibody therapeutics. For more than 20 years, its
passionate, innovative and collaborative team has invented
next-generation antibody technology platforms and leveraged
translational research and data sciences, which has resulted in a
proprietary pipeline including bispecific T-cell engagers,
next-generation immune checkpoint modulators, effector function
enhanced antibodies and antibody-drug conjugates. To help develop
and deliver novel antibody therapies to patients, Genmab has formed
20+ strategic partnerships with biotechnology and pharmaceutical
companies. By 2030, Genmab’s vision is to transform the lives of
people with cancer and other serious diseases with
Knock-Your-Socks-Off (KYSO™) antibody medicines.
Established in 1999, Genmab is headquartered in Copenhagen,
Denmark with locations in Utrecht, the Netherlands, Princeton, New
Jersey, U.S. and Tokyo, Japan. For more information, please visit
Genmab.com and follow us on Twitter.com/Genmab.
This Media Release contains forward looking statements. The
words “believe,” “expect,” “anticipate,” “intend” and “plan” and
similar expressions identify forward looking statements. Actual
results or performance may differ materially from any future
results or performance expressed or implied by such statements. The
important factors that could cause our actual results or
performance to differ materially include, among others, risks
associated with pre-clinical and clinical development of products,
uncertainties related to the outcome and conduct of clinical trials
including unforeseen safety issues, uncertainties related to
product manufacturing, the lack of market acceptance of our
products, our inability to manage growth, the competitive
environment in relation to our business area and markets, our
inability to attract and retain suitably qualified personnel, the
unenforceability or lack of protection of our patents and
proprietary rights, our relationships with affiliated entities,
changes and developments in technology which may render our
products or technologies obsolete, and other factors. For a further
discussion of these risks, please refer to the risk management
sections in Genmab’s most recent financial reports, which are
available on www.genmab.com and the risk factors included in
Genmab’s most recent Annual Report on Form 20-F and other filings
with the U.S. Securities and Exchange Commission (SEC), which are
available at www.sec.gov. Genmab does not undertake any obligation
to update or revise forward looking statements in this Media
Release nor to confirm such statements to reflect subsequent events
or circumstances after the date made or in relation to actual
results, unless required by law.
Genmab A/S and/or its subsidiaries own the following trademarks:
Genmab®; the Y-shaped Genmab logo®; Genmab in combination with the
Y-shaped Genmab logo®; HuMax®; DuoBody®; HexaBody®; DuoHexaBody®,
HexElect® and KYSO™. EPCORE™, EPKINLY®, TEPKINLY® and their designs
are trademarks of AbbVie Biotechnology Ltd.
______________________________ i Lymphoma Research Foundation
official website. https://lymphoma.org/aboutlymphoma/nhl/fl/.
Accessed June 2023. ii Ma S. Risk factors of follicular lymphoma.
Expert Opin Med Diagn. 2012;6:323–33. doi:
10.1517/17530059.2012.686996. iii Luminari S, Bellei M, Biasoli I,
Federico M. Follicular lymphoma—treatment and prognostic factors.
Rev Bras Hematol Hemoter. 2012;34:54–9. doi:
10.5581/1516-8484.20120015. iv Link BK, et al. Second-Line and
Subsequent Therapy and Outcomes for Follicular Lymphoma in the
United States: Data From the Observational National LymphoCare
Study. Br J Haematol 2019;184(4):660-663. v Ren J, et al. Economic
Burden and Treatment Patterns for Patients With Diffuse Large
B-Cell Lymphoma and Follicular Lymphoma in the USA. J Comp Eff Res
2019;8(6):393-402. vi Lymphoma Research Foundation official
website.
https://lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/follicular-lymphoma/relapsedfl/.
Accessed November 2023. vii Engelberts PJ, Hiemstra IH, de Jong B,
et al. DuoBody-CD3xCD20 induces potent T-cell-mediated killing of
malignant B cells in preclinical models and provides opportunities
for subcutaneous dosing. EBioMedicine. 2020;52:102625. DOI:
10.1016/j.ebiom.2019.102625.
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David Freundel, Senior Director, Global Communications &
Corporate Affairs T: +1 609 430 2481m; E: dafr@genmab.com
Andrew Carlsen, Vice President, Head of Investor Relations T:
+45 3377 9558; E: acn@genmab.com
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