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Tarlatamab in Previously Treated Small Cell Lung Cancer: A Real-World Experience in a Predominantly Hispanic
Santiago Sucre1, Chinmay Jani1,2, Dan Morgenstern-Kaplan1,2
1Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, USA.
Background:
SCLC remains an aggressive malignancy with limited therapeutic options after progression. Tarlatamab, a DLL3-directed bispecific T-cell engager, has a demonstrated survival benefit in clinical trials, but real-world data remain limited. We evaluated the safety, radiographic response, and treatment durability of Tarlatamab in a real-world cohort treated at a single academic center.
Methods:
We performed a retrospective review of patients with extensive-stage SCLC who received Tarlatamab at the University of Miami Sylvester Comprehensive Cancer Center between 2024 and 31 October 2025. Demographic, clinical, radiographic, and toxicity data were abstracted from electronic medical records. Radiographic response was defined as partial response or stable disease on follow-up imaging. PFS and overall survival OS were estimated using the Kaplan-Meier method.
Results:
Twenty-three patients were included (median age 72 years), of whom 61% were Hispanic and 61% had brain metastases prior to treatment. Forty-three percent had received two or more prior lines of therapy. CRS and ICANS occurred primarily during Cycle 1 and were limited to grade 1-2 events, with no grade ≥3 toxicities. Median time on treatment was 92 days with a median of four cycles. Among 18 evaluable patients, partial response was observed in 27.7% and stable disease in 16.7%, yielding a disease control rate of 44.4%. Median PFS was 139 days and median OS was 323 days (95% CI, 31-614).
Conclusions:
In a predominantly Hispanic, heavily pre-treated real-world population with high CNS disease burden, Tarlatamab demonstrated feasible administration, manageable immune-mediated toxicity, and clinically meaningful antitumor activity.
Insights
Tarlatamab, a DLL3-targeted therapy, showed manageable toxicity and antitumor activity in a real-world study of extensive-stage small cell lung cancer (SCLC). This bispecific T-cell engager offers a survival benefit for heavily pre-treated patients with brain metastases.
Area of Science:
- Oncology
- Immunotherapy
- Clinical Research
Background:
- Small cell lung cancer (SCLC) is aggressive with limited treatment options post-progression.
- Tarlatamab, a DLL3-directed bispecific T-cell engager, has shown survival benefits in clinical trials.
- Real-world data on Tarlatamab's efficacy and safety are limited.
Purpose of the Study:
- To evaluate the safety, radiographic response, and treatment durability of Tarlatamab in a real-world SCLC cohort.
- To assess Tarlatamab's effectiveness in a heavily pre-treated population with brain metastases.
Main Methods:
- Retrospective review of 23 extensive-stage SCLC patients treated with Tarlatamab.
- Data abstraction from electronic medical records for demographic, clinical, radiographic, and toxicity information.
- Kaplan-Meier method used for progression-free survival (PFS) and overall survival (OS) estimation.
Main Results:
- The cohort was predominantly Hispanic (61%) with a high rate of brain metastases (61%) and prior therapies (43% received ≥2 lines).
- Cytokine release syndrome (CRS) and immune-effector cell-associated neurotoxicity syndrome (ICANS) were primarily grade 1-2, occurring mainly in Cycle 1.
- Disease control rate was 44.4% (27.7% partial response, 16.7% stable disease), with median PFS of 139 days and median OS of 323 days.
Conclusions:
- Tarlatamab demonstrated feasible administration and manageable immune-mediated toxicity in a real-world, heavily pre-treated SCLC population with high CNS disease burden.
- The therapy showed clinically meaningful antitumor activity, supporting its use in this patient group.
- Real-world data confirm Tarlatamab's potential as a therapeutic option for advanced SCLC.
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