A case of diffuse large B-cell lymphoma achieving complete remission with epcoritamab after pseudoprogression.
Ai Takahara, Yu Yagi, Yusuke Kanemasa et al.
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Case in brief
A 58-year-old male with diffuse large B-cell lymphoma (DLBCL) achieved complete remission after fourth-line therapy but experienced pelvic lymphadenopathy 26 months later, indicating relapse. After failing radiotherapy and chemotherapy, he received epcoritamab as a seventh-line treatment. Despite initial symptoms of cytokine release syndrome and abdominal pain, imaging revealed pseudoprogression. Continued treatment led to a complete metabolic response after three cycles, maintained through nine cycles.
What made this case unusual
The case illustrates the occurrence of pseudoprogression during epcoritamab therapy, a phenomenon not commonly reported with bispecific antibodies in DLBCL.
Diagnostic / clinical pearl
Clinicians should consider the possibility of pseudoprogression in patients receiving epcoritamab, as it may mimic disease progression but can resolve with continued treatment.
Why it matters
Recognizing pseudoprogression is crucial for managing treatment decisions and avoiding premature discontinuation of effective therapies in DLBCL.