Glofitamab and epcoritamab for large B cell lymphoma: a real-world retrospective UK analysis of efficacy, tolerability, and impact of treatment sequencing

Abstract

Glofitamab and epcoritamab are CD3xCD20 bispecific antibodies licensed for relapsed/refractory large B cell lymphoma (RR LBCL), yet real-world data are limited. Data were collected from 332 patients (219 glofitamab, 113 epcoritamab) across 34 UK centres (November 2023-May 2025). This high-risk cohort had median 2 prior lines of treatment; 179 (55%) primary refractory disease; 81 (25%) ECOG ?2; 152 (50%) prior Chimeric Antigen Receptor T-cell therapy; and 232 (78%) pivotal-trial ineligible. 7 patients died before treatment initiation, 1 patient was yet to start treatment, of 324 treated patients, 28% had cytokine release syndrome (CRS), predominately grade 1/2 (82/90). Overall response rate (ORR) and complete response rate (CRR) were 43% and 24%, respectively, while for trialeligible patients the CRR was 43%. At a median 10.0 months follow-up (IQR 5.3-15.0), median progression-free survival (PFS) was 3.1 months (95% confidence interval [CI], 2.5-4.2), median overall survival (OS) was 6.9 months (95% CI, 4.9-10.8). For patients not completing cycle 2, 6-month OS was 4% (95% CI 1-11%). Median duration of complete response was not reached. Refractoriness to prior line of treatment (HR 2.89, 95% CI 1.73-4.81, p=0.007), elevated LDH (HR 2.62, 95% CI 1.74-3.93. p=0.001), bendamustine exposure within 6 months (HR 1.62, 95% CI 1.14-2.30, p=0.007) and ECOG 1 (HR 2.70, 95% CI 1.52-4.79, p=0.001) or 2 (HR 6.49, 95% CI 3.47-12.01, p.