Sustained Clinical Benefit and Intracranial Activity of Tarlatamab in Previously Treated Small Cell Lung Cancer: DeLLphi-300 Trial Update

Affiliations
  • 1University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH.
  • 2Translational Oncology/Early Clinical Trial Unit (ECTU), Bavarian Cancer Research Center, National Center for Tumor Diseases, Comprehensive Cancer Center Mainfranken and University Hospital Würzburg, Würzburg, Germany.
  • 3Department of Therapeutic Innovation and Early Phase Trials, Gustave Roussy, Villejuif, France.
  • 4Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain.
  • 5Department of Medical Oncology, Chris O’Brien Lifehouse, Sydney, Australia.
  • 6Faculty of Medicine and Health, School of Medicine, University of Sydney, Sydney, Australia.
  • 7Comprehensive Cancer Center, Pelotonia Institute for Immuno-Oncology, The Ohio State University, Columbus, OH.
  • 8Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  • 9Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
  • 10Department of Medical Oncology, Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN.
  • 11Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
  • 12Department of Oncology, Vaud University Hospital, Lausanne, Switzerland.
  • 13Fox Chase Cancer Center, Philadelphia, PA.
  • 14Department of Medical Oncology, Hospital Universitario del Vall d’Hebron, Barcelona, Spain.
  • 15Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • 16Division of Hematology and Oncology, Department of Internal Medicine, Henry Ford Cancer Institute/Henry Ford Health System, Detroit, MI.
  • 17Amgen Inc, Thousand Oaks, CA.
  • 18Hospital Universitario 12 de Octubre, CNIO-H12o Lung Cancer Unit, Complutense University and Ciberonc, Madrid, Spain.

Abstract

JCO .Tarlatamab, a bispecific T-cell engager immunotherapy targeting delta-like ligand 3, has shown durable anticancer activity and manageable safety in previously treated small cell lung cancer (SCLC) in DeLLphi-300 phase I and DeLLphi-301 phase II trials. Here, we report extended follow-up of DeLLphi-300 (median follow-up, 12.1 months [range, 0.2-34.3]) in fully enrolled cohorts treated with tarlatamab ≥10 mg dose administered once every two weeks, once every three weeks, or once on day 1 and once on day 8 of a 21-day cycle (N = 152). Overall, the objective response rate (ORR) was 25.0%; the median duration of response (mDOR) was 11.2 months (95% CI, 6.6 to 22.3), and the median overall survival (mOS) was 17.5 months (95% CI, 11.4 to not estimable [NE]). Among 17 patients receiving 10 mg tarlatamab once every two weeks, the ORR was 35.3%, the mDOR was 14.9 months (95% CI, 3.0 to NE), the mOS was 20.3 months (95% CI, 5.1 to NE), and 29.4% had sustained disease control with time on treatment ≥52 weeks. No new safety signals were identified. In modified Response Assessment in Neuro-Oncology Brain Metastases analyses, CNS tumor shrinkage of ≥30% was observed in 62.5% of patients (10 of 16) who had a baseline CNS lesion of ≥10 mm, including in a subset of patients with tumor shrinkage long after previous brain radiotherapy. In DeLLphi-300 extended follow-up, tarlatamab demonstrated unprecedented survival and potential findings of intracranial activity in previously treated SCLC.