Tarlatamab in Small-Cell Lung Cancer after Platinum-Based Chemotherapy

Area of Science:

• Oncology
• Immunotherapy
• Clinical Trials

Background:

• Tarlatamab, a DLL3-directed T-cell engager, has accelerated approval for small-cell lung cancer.
• Efficacy of tarlatamab versus chemotherapy in relapsed/refractory small-cell lung cancer remains unknown.

Purpose of the Study:

• To compare the efficacy and safety of tarlatamab versus chemotherapy as second-line treatment for small-cell lung cancer.

Main Methods:

• Phase 3, multinational, open-label trial comparing tarlatamab to chemotherapy (topotecan, lurbinectedin, or amrubicin).
• Randomized assignment of 509 patients; primary endpoint was overall survival.
• Key secondary endpoints included progression-free survival and patient-reported outcomes.

Main Results:

• Tarlatamab significantly improved overall survival (median 13.6 months vs. 8.3 months; HR 0.60; P<0.001).
• Tarlatamab showed benefits in progression-free survival and reduced cancer-related dyspnea and cough.
• Lower incidence of grade 3+ adverse events (54% vs. 80%) and treatment discontinuation (5% vs. 12%) with tarlatamab.

Conclusions:

• Tarlatamab demonstrated superior overall survival compared to chemotherapy in patients with platinum-refractory small-cell lung cancer.
• Tarlatamab offers a more effective and safer treatment option for this patient population.