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ADVERSE REACTIONS IN THE EPCORE™ NHL-1 TRIAL

CRS-related adverse reactions were predictable, manageable, and resolvable1*

Predictable:

95% of CRS events occurred in the first cycle2

Manageable: 

6.6% adverse event–related discontinuation3

  • Discontinuation due to CRS or ICANS occurred in 1 patient each (0.6%)3
  • 1 patient (0.6%) experienced a fatal adverse reaction (ICANS)3

Resolvable: 

CRS resolved in 100%1,3

  • Median duration of CRS events was 2 days (range: 0.1-27 days)

Manageable safety profile2

Only 6.6% of patients discontinued subcutaneous TEPKINLY due to adverse reactions.3

 

Adverse reactions reported in patients in EPCORE™ NHL-13

System organ class/preferred term or adverse reactionAll gradesGrade 3-4
Infections and infestations
Viral infectionaVery commonCommon
PneumoniabVery commonCommon
Upper respiratory tract infectioncCommonCommon
Fungal infectionsdCommon 
SepsiseCommonCommon
CellulitisCommonCommon
Neoplasm benign, malignant, and unspecified (including cysts and polyps)
Tumour flareCommon 
Blood and lymphatic system disorders
NeutropeniafVery commonVery common
AnaemiagVery commonVery common
ThrombocytopeniahVery commonCommon
LymphopeniaiCommonCommon
Febrile neutropeniaCommonCommon
Immune system disorders
Cytokine release syndromejVery commonCommon
Metabolism and nutrition disorders
Decreased appetiteVery commonUncommon
HypophosphatemiaCommonCommon
HypokalemiaCommonUncommon
HypomagnesemiaCommon 
Tumour lysis syndromekCommonCommon
Nervous system disorders
HeadacheVery commonUncommon
Immune effector cell-associated neurotoxicity syndromejCommon 
Cardiac disorders
Cardiac arrhythmiaslVery commonCommon
Respiratory, thoracic, and mediastinal disorders
Pleural effusionCommonCommon
Gastrointestinal disorders
Abdominal painmVery commonCommon
NauseaVery commonCommon
DiarrhoeaVery common 
VomitingVery commonUncommon
Skin and subcutaneous tissue disorders
RashnCommon 
PruritusCommon 
Musculoskeletal and connective tissue disorders
Musculoskeletal painoVery commonCommon
General disorders and administration site conditions
FatiguepVery commonCommon
Injection site reactionsqVery common 
PyrexiarVery commonUncommon
OedemasVery commonCommon
Investigations
Alanine aminotransferase increasedCommonUncommon
Aspartate aminotransferase increasedCommonCommon
Blood creatinine increasedCommon 
Blood sodium decreasedtCommonUncommon
Alkaline phosphatase increasedCommon 

Adverse reactions were graded using NCI CTCAE version 5.0.

  • TLS has been reported in patients receiving TEPKINLY. Patients at an increased risk for TLS are recommended to receive hydration and prophylactic treatment with a uric acid-lowering agent. Patients should be monitored for signs or symptoms of TLS, especially patients with high tumour burden or rapidly proliferative tumours and patients with reduced renal function1
  • The most common adverse reactions (≥20%) were CRS, fatigue, neutropenia, injection site reactions, musculoskeletal pain, abdominal pain, pyrexia, nausea, and diarrhoea1
  • Serious adverse reactions occurred in 52% of patients. The most frequent serious adverse reaction (≥10%) was CRS (31%). Seven patients (4.2%) experienced a fatal adverse reaction (pneumonia in 3 [1.8%] patients, viral infection in 3 [1.8%] patients, and ICANS in 1 [0.6%])1

*“Predictable” refers to timing of CRS: Most CRS events occurred following the first full dose.2

Adverse reactions for TEPKINLY from clinical studies are listed by MedDRA system organ class and are based on the following convention: 

  • very common (≥1/10); 
  • common (≥1/100 to <1/10); 
  • uncommon (≥1/1000 to <1/100); 
  • rare (≥1/10,000 to <1/1000); 
  • very rare (<1/10,000). 

Actual EPCORE study start date: June 26, 2018. Estimated Primary Completion Date: January 2025.4

aViral infection includes asymptomatic COVID-19, COVID-19, cytomegalovirus infection, cytomegalovirus infection reactivation, gastroenteritis viral, herpes simplex, herpes zoster, and oral herpes.

bPneumonia includes COVID-19 pneumonia and pneumonia.

cUpper respiratory tract infection includes laryngitis, pharyngitis, respiratory syncytial virus infection, rhinitis, rhinovirus infection, and upper respiratory tract infection.

dFungal infection includes Candida infection, oesophageal candidiasis, and oral candidiasis.

eSepsis includes bacteraemia, sepsis, and septic shock.

fNeutropenia includes neutropenia and neutrophil count decreased.

gAnaemia includes anaemia and serum ferritin decreased.

hThrombocytopenia includes platelet count decreased and thrombocytopenia.

iLymphopenia includes lymphocyte count decreased and lymphopenia.

jCRS and ICANS adverse reactions were graded based on American Society for Transplantation and Cellular Therapy criteria.

kTumour lysis syndrome was graded based on Cairo-Bishop criteria.

lCardiac arrhythmias include bradycardia, sinus bradycardia, sinus tachycardia, supraventricular tachycardia, and tachycardia.

mAbdominal pain includes abdominal discomfort, abdominal pain, abdominal pain lower, abdominal pain upper, and abdominal tenderness.

nRash includes rash, rash erythematous, rash maculopapular, and rash pustular.

oMusculoskeletal pain includes back pain, bone pain, flank pain, musculoskeletal chest pain, musculoskeletal pain, myalgia, neck pain, non-cardiac chest pain, pain, pain in extremity, and spinal pain.

pFatigue includes asthenia, fatigue, and lethargy.

qInjection site reactions include injection site bruising, injection site erythema, injection site hypertrophy, injection site inflammation, injection site mass, injection site pain, injection site pruritus, injection site rash, injection site reaction, injection site swelling, and injection site urticaria.

rPyrexia includes body temperature increased and pyrexia.

sOedema includes face oedema, generalised oedema, oedema, oedema peripheral, and peripheral swelling.

tBlood sodium decreased includes blood sodium decreased and hyponatraemia.

 

Manageable safety profile: 10.8% patients discontinued subcutaneous TEPKINLY due to adverse reactions4

[SELECT ONLY ONE OF THE FOLLOWING DATA CUTS]

Select adverse events and AEs of special interest reported in patients with R/R DLBCL treated with TEPKINLY in EPCORE NHL-1 (n=139)

DLBCL, data cut-off: June 30, 2022
All grades, n (%)Grade ≥3, n (%)
Neutropenia, 35 (25.2%)Neutropenia, 24 (17.3%)
Anaemia, 28 (20.1%)Anaemia, 16 (11.5%)
Thrombocytopenia, 20 (14.4%)Thrombocytopenia, 8 (5.8%)
Immune effector cell-associated neurotoxicity syndrome, 9 (6.5%)Immune effector cell-associated neurotoxicity syndrome, 0 (0%)
CRS, 68 (48.9%)CRS, 5 (3.6%)
Clinical tumour lysis syndrome, 2 (1.4%)Clinical tumour lysis syndrome, 2 (1.4%)
Fatigue, 33 (23.7%)Fatigue, 3 (2.2%)
Headache, 18 (12.9%)Headache, 1 (0.7%)
Nausea, 31 (22.3%)
Diarrhoea, 30 (21.6%)
Vomiting, 19 (13.7%)
Nausea, 2 (1.4%)
Diarrhoea, 0 (0%)
Vomiting, 1 (0.7%)
Rash, 9 (6.5%)
Pruritus, 9 (6.5%)
Rash, 0 (0%)
Pruritus, 0 (0%)
Injection site reactions, 29 (20.9%)
Pyrexia, 34 (24.5%)
Injection site reactions, 0 (0%)
Pyrexia, 1 (0.7%)

 

Manageable safety profile: 12.2% patients discontinued subcutaneous TEPKINLY due to adverse reactions4


Select adverse events and AEs of special interest reported in patients with R/R DLBCL treated with TEPKINLY in EPCORE NHL-1 (n=139)

DLBCL, data cut-off: November 18, 2022
All grades, n (%)Grade ≥3, n (%)
Neutropenia, 35 (25.2%)Neutropenia, 24 (17.3%)
Anaemia, 29 (20.9%)Anaemia, 18 (12.9%)
Thrombocytopenia, 18 (12.9%)Thrombocytopenia, 7 (5%)
CRS, 69 (49.6%)CRS, 5 (3.6%)
Immune effector cell-associated neurotoxicity, 9 (6.5%)Immune effector cell-associated neurotoxicity, 1 (0.7%)
Tumour lysis syndrome, 2 (1.4)Tumour lysis syndrome, 2 (1.4)
Headache, 18 (12.9)Headache, 1 (0.7)
Fatigue, 33 (23.7%)Fatigue, 3 (2.2%)
Nausea, 32 (23.0%)Nausea, 2 (1.4%)
Abdominal pain, 30 (21.6%)Abdominal pain, 30 (0%)
Diarrhoea, 30 (21.6%)Diarrhoea, 0 (0)
Vomiting, 19 (13.7%)Vomiting, 1 (0.7%)
Rash, 9 (6.5%)Rash, 0 (0%)
Pruritus, 9 (6.5%)Pruritus, 0 (0%)
Injection site reactions, 26 (18.7%)Injection site reactions, 0 (0%)
Pyrexia, 30 (21.6%)Pyrexia, 0 (0%)

Dose delays due to adverse reactions occurred in 32% of patients3

 

Chart

 

Serious infections occurred in 25% of patients treated with TEPKINLY3‡

  • Serious infections, including fatal infections and viral reactivation, have been observed
  • Administration of TEPKINLY should be avoided in patients with clinically significant active systemic infections
  • The most frequent types of serious infections were COVID-19, COVID-19 pneumonia,* sepsis, upper respiratory infection, bacteraemia, and septic shock
Chart

Fatal serious infections occurred in 7 patients (4.2%)

*Actual EPCORE™ NHL-1 study start date: June 26, 2018. Estimated Primary Completion Date: January 2025.5


[INCLUDE SAFETY INFORMATION PER LOCAL REGULATIONS]

 

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Learn more about CRS and ICANS events.

 

 

C1D1=cycle 1, day 1; C1D8=cycle 1, day 8; C1D15=cycle 1, day 15; C1D22=cycle 1, day 22; C2D1+=cycle 2, days 1+; CRS=cytokine release syndrome; ICANS=immune effector cell-associated neurotoxicity syndrome; NHL=non-Hodgkin lymphoma; TLS=tumour lysis syndrome.

TEPKINLY as monotherapy is indicated for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after two or more lines of systemic therapy.3

References: 1. Thieblemont C, Phillips T, Ghesquieres H, et al. Epcoritamab, a novel, subcutaneous CD3xCD20 bispecific T-cell–engaging antibody, in relapsed or refractory large B-cell lymphoma: dose expansion in a phase I/II trial. J Clin Oncol. Published online December 22, 2022. doi:10.1200/JCO.22.01725 2. Thieblemont C, Phillips T, Ghesquieres H, et al. Epcoritamab, a novel, subcutaneous CD3xCD20 bispecific T-cell–engaging antibody, in relapsed or refractory large B-cell lymphoma: dose expansion in a phase I/II trial. J Clin Oncol. (suppl). Published online December 22, 2022. doi:10.1200/JCO.22.01725 3. TEPKINLY Summary of Product Characteristics. AbbVie Inc. 4. Data on file, AbbVie Inc. 5. First-in-Human (FIH) Trial in Patients with Relapsed, Progressive or Refractory B-Cell Lymphoma (EPCORE™ NHL-1). ClinicalTrials.gov identifier: NCT03625037. Updated May 31, 2023. Accessed June 20, 2023. https://www.clinicaltrialsgov/ct2/show/NCT03625037

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