Research brief
Small-cell lung cancer (SCLC) is challenging to treat, particularly when it recurs after initial therapy. Tarlatamab, a bispecific T-cell engager, targets the Delta-like ligand-3 (DLL3) on tumour cells, connecting them with T-cells to trigger an immune response. Recent trials suggest that tarlatamab could significantly improve overall survival for patients with relapsed SCLC, providing a new option for those who have exhausted standard treatments.
Key points
- Tarlatamab targets DLL3 on tumour cells.
- Improves survival in relapsed SCLC cases.
- Manages immune-related side effects effectively.
Mechanism of Action
Tarlatamab functions as a bispecific T-cell engager, a type of immunotherapy that connects T-cells to cancer cells. It specifically targets DLL3, a protein found on the surface of SCLC cells but not on normal tissues. By binding to DLL3 on tumour cells and CD3 on T-cells, tarlatamab enables the immune system to directly attack and kill cancer cells.
Clinical Trial Findings
The Phase III DeLLphi-304 trial has demonstrated tarlatamab’s effectiveness in relapsed SCLC. Patients treated with tarlatamab experienced a statistically significant improvement in overall survival compared to those receiving standard second-line chemotherapy. This trial indicates tarlatamab’s potential to change the treatment landscape for this aggressive cancer.
Managing Side Effects
While tarlatamab has shown positive outcomes, it is associated with side effects. Immune-mediated toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) have been observed, particularly during early treatment cycles. These side effects are generally manageable with supportive care and immunosuppressive therapies, including corticosteroids and monoclonal antibodies like tocilizumab.
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