Bispecific T-cell engagers (BiTE): a review of tarlatamab in small cell lung cancer

Small-cell lung cancer remains one of the most aggressive lung malignancies, a neuroendocrine tumor with paraneoplastic features; it often grows centrally in the lung as opposed to peripheral cancers. Small-cell lung cancer (SCLC) is managed by chemotherapy and/or radiation. Due to its aggressive nature and poor prognosis, there is a need for more targeted and effective therapies; hence, the emergence of tarlatamab, a bispecific T-cell engager (BiTE), shows promise in current clinical trials. This review critically assesses the efficacy of tarlatamab in demonstrating antineoplastic activity. We also assess the safety profile, overall survival rate, progression-free survival, duration of response, and immunogenicity.

To conduct this review, a thorough preliminary search was conducted to identify key studies that evaluated the medication at specific doses among patients with small-cell lung cancer.

The positive and negative outcomes are discussed in this review, along with safety, tolerability, and performance in relapsed and refractory SLCL and biomarker insights. The adverse effects were generally manageable, most occurring during the first treatment cycle. The unique mechanism of action of tarlatamab was described with a comparative analysis with other novel monoclonal antibodies and chemotherapies for managing small-cell lung cancer (SCLC). The studies evaluated in this review are not without limitations.

Tarlatamab's use must be evaluated in a more heterogeneous population with different demographics, comorbidities, and a larger patient population. The possibility of combination therapy studies should also be evaluated in future studies to increase the efficacy of tarlatamab.