Long-term follow-up from the Epcor-NHL1 trial reveals that epcoritamab monotherapy can produce highly durable complete responses in relapsed/refractory large B-cell lymphoma. With some patients remaining in remission for over 54 months, the therapy is positioned as a potential curative option in this setting.

The CLL-17 trial, the first modern head-to-head comparison of major CLL strategies, showed no difference in 3-year survival between fixed-duration and continuous therapy. This landmark finding provides strong evidence that stopping treatment is a safe and effective strategy that reduces long-term toxicity for patients.

In follicular lymphoma, the treatment goal is durable remission with manageable toxicity, not necessarily a cure. Therefore, clinicians frequently prefer using a bispecific antibody first, reserving the more complex and toxic CAR-T cell therapy for transformed disease or after a bispecific fails.

Not all CD20-targeting bispecifics can be combined with rituximab. Mosunetuzumab binds the same epitope, causing competition. However, glofitamab and epcoritamab bind different epitopes, allowing for logical and potentially synergistic combinations with rituximab-based regimens.

When choosing between novel combinations in relapsed follicular lymphoma, a logical strategy is to use tafasitamab-lenalidomide-rituximab (Tafa-R2) first. After progression, single-agent epcoritamab remains highly effective. The reverse is not true, as tafasitamab monotherapy would not be effective after epcoritamab-R2 failure, making the initial choice critical.

To manage infection risk and improve quality of life, experts are quickly reducing bispecific antibody dosing frequency (e.g., to monthly) once a response is achieved. This real-world practice deviates from rigid trial schedules to optimize patient outcomes.

Three-year data for odronextumab, given until progression in follicular lymphoma, reveals a high rate of severe (Grade 3+) infections (45%), including fatal events. This highlights a critical safety concern with continuous dosing and strengthens the clinical argument for using fixed-duration bispecific regimens to mitigate long-term toxicity.

While many CLL patients prefer fixed-duration therapy to avoid continuous medication, this preference is often overridden by practical logistics. The burden of increased monitoring and frequent clinic visits associated with fixed-duration regimens leads some patients to opt for continuous therapy instead.

Long-term follow-up from the pivotal epcoritamab trial reveals that 46% of DLBCL patients who achieve a complete remission maintain it at four years. This durability provides strong evidence that bispecific monotherapy, not just CAR-T, can be a curative treatment for a subset of patients.