Early Experience with Tarlatamab (T-Cell Engagers) for Extensive-Stage Small Cell Lung Cancer (ES-SCLC) in Canada:...

Area of Science:

• Oncology
• Immunotherapy
• Clinical Pharmacy

Background:

• Bispecific T-cell engagers (TCEs) are increasingly used in cancer treatment.
• The Canadian medical oncology community has limited experience with TCEs.
• Tarlatamab, a novel DLL3-targeted TCE, is approved for extensive-stage small cell lung cancer (ES-SCLC).

Purpose of the Study:

• To emphasize the importance of sharing early clinical experiences with TCEs, particularly tarlatamab.
• To inform best practices for the safe and effective adoption of TCEs in Canada.
• To guide the development of clinical pathways for managing TCE-related toxicities.

Main Methods:

• Review of early clinical experiences with tarlatamab administration.
• Analysis of safety profiles, monitoring requirements, and management strategies for TCE-related adverse events (AEs).
• Identification of key elements for developing dedicated institutional protocols.

Main Results:

• Tarlatamab is associated with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).
• Dedicated protocols involving multidisciplinary teams are necessary for prompt recognition and management of AEs.
• Sharing insights on administration, dose ramp-up, monitoring, and AE management can optimize protocol development.

Conclusions:

• Sharing early adopter insights facilitates efficient protocol development for tarlatamab and other TCEs.
• Lessons learned regarding healthcare provider roles and care transitions are vital for integration.
• Robust clinical pathways are essential for the safe and efficient delivery of TCEs in Canada.