Real-world retrospective study of tarlatamab for relapsed extensive-stage small cell lung cancer

Tarlatamab is a CD3/delta-like ligand 3 bispecific T-cell engager, approved in 2024 for relapsed extensive-stage small cell lung cancer (ES-SCLC). A retrospective study at MD Anderson Cancer Center (Houston, TX) investigated safety and efficacy of tarlatamab for real-world patients with ES-SCLC. From July 1, 2024, to February 15, 2025, 27 patients received tarlatamab (media age 68 years; range 43-83; 56% women). Nine patients had no baseline brain metastases (BMs), and 11 patients had active, untreated BMs. The median duration of follow-up was 3 months. Of the 22 patients evaluable for response, four had partial response (18.2%), seven had stable disease (31.8%), and eleven had progressive disease (50%). Median progression-free survival was 5.9 months (95% CI 2.6-NR). Of the 14 patients with prior BMs and serial brain MRI, two had complete response, one had partial response, nine had stable disease, and only two had progressive disease. Of the four patients without BM, none had new intracranial disease after starting tarlatamab. Ten patients (37%) developed CRS (one grade ≥3), and eight patients (30%) had ICANS (four grade ≥3). The authors conclude that in this real-world cohort of relapsed ES-SCLC patients, tarlatamab demonstrated both intracranial and extracranial efficacy; the toxicity profile showed similar CRS but higher ICANS compared with those reported in clinical trials.