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Outcomes of Concurrent Radiotherapy With Tarlatamab in Extensive-Stage Small Cell Lung Cancer From the DLL3 PanTUMOR
Diana Kim1, Sarah Blocker1, Courtney C Cavalieri2
1Medical Oncology, The University of Kansas Cancer Center, Westwood, KS.
Clinical Lung Cancer
|February 26, 2026
Summary
Concurrent radiotherapy with tarlatamab is safe and effective for extensive-stage small cell lung cancer (ES-SCLC). This combination shows promising tumor response and a trend toward improved survival, warranting further investigation.
Area of Science:
- Oncology
- Radiotherapy
- Pharmacology
Background:
- Small cell lung cancer (SCLC) is aggressive, with radiotherapy integral to treatment.
- Tarlatamab offers improved survival over chemotherapy as a second-line therapy.
- Limited data exists on concurrent radiotherapy with tarlatamab in extensive-stage SCLC (ES-SCLC).
Purpose of the Study:
- To evaluate the safety and efficacy of concurrent radiotherapy with tarlatamab in ES-SCLC patients.
- To assess real-world outcomes using the DLL3 PanTUMOR database.
Main Methods:
- Multicenter retrospective analysis of 109 adults with ES-SCLC treated between May 2024 and July 2025.
- Comparison of concurrent radiotherapy (n=23) versus non-radiotherapy (n=86) arms.
- Primary endpoint: Grade ≥ 3 radiotherapy-related adverse events; Secondary endpoints: Overall survival (OS), progression-free survival (PFS), tumor response, and toxicity.
Main Results:
- Concurrent radiotherapy was predominantly stereotactic (56.5%), often to the brain.
- Low rate of severe (≥ grade 3) radiotherapy-related toxicity (4.3%).
- Median OS not reached (concurrent RT) vs. 7.5 months (non-RT); Median PFS 4.6 vs. 3.1 months.
- High local tumor regression rate (83.3%) in evaluable patients.
- No delayed CRS or ICANS observed post-tarlatamab step-up.
Conclusions:
- Concurrent radiotherapy with tarlatamab is safe in ES-SCLC.
- The combination demonstrates frequent local tumor response.
- A trend toward improved OS suggests further investigation is warranted.
