Tarlatamab-Imdelltra clinical trial progress and summary of experience in patients with small cell lung cancer

Tarlatamab-Imdelltra has received great attention in the global small cell lung cancer (SCLC) research field in recent years. The core reason is that the drug serves as a DLL3 bispecific T Cell Connector (BiTE) provides an immune cell activation route different from traditional chemotherapy for relapsed or refractory SCLC . SCLC One of the characteristics is the high expression of DLL3 while normal tissue expression is very low, making it an ideal target. Imdelltra has shown positive signals such as increased objective response rate and improved disease control rate in multiple international trials, giving new hope to the SCLC treatment that has long lacked breakthroughs.

In the international II phase trial DeLLphi-301 , Tarlatamab relapsed after at least two lines of therapy SCLC Clinically meaningful efficacy performance has been achieved in patients, including a higher objective response rate, prolonged median response duration, and long-term remission in some patients. The trial results also showed that some patients still achieved significant tumor shrinkage despite rapid disease progression, suggesting that they still have potential mechanism-replenishing value after resistance to immunotherapy. In addition, research data shows that it has an early onset of effect, and changes in tumor volume can be observed within the first few weeks, and its clinical application value has gradually become apparent.

In real-world experience, some relapsed SCLC patients progressed again after initial treatment with platinum-based chemotherapy and immune checkpoint inhibitors (PD-L1/PD-1), and Tarlatamab As a back-line treatment, some patients have reduced tumor burden, improved respiratory symptoms, and improved quality of life. Feedback from doctors pointed out that the drug is more advantageous for patients with high DLL3 expression, but even patients with moderate expression levels may benefit. In addition, the immune cell redirection mechanism is different from traditional immune checkpoint inhibitors, so patients with previous immune resistance may still bring opportunities, which is of particular concern in clinical practice.

In terms of safety, Tarlatamab still continues BiTE Among the typical adverse reactions of similar drugs, cytokine release syndrome (CRS) is the most common problem, but most of them are in the 1–2 grade, which can be effectively managed through stepped dose administration, pretreatment drugs and monitoring. Some patients may also experience immune-related fatigue, fever, loss of appetite, and hypotension, but the overall condition is well controllable. Neurotoxicity has also been reported in studies, but at a relatively lower rate than with other TT cell redirecting drugs. Combining clinical data and real-world observations, the risk-benefit ratio of Tarlatamab is currently considered to be at an acceptable and promising level, providing a new direction for future back-line immunotherapy strategies for SCLC.

Keyword tag:

Tarlatamab, Imdelltra, small cell lung cancer, SCLC, DLL3 , bispecificTcell connector, BiTE, clinical trials, efficacy, safety, cytokine release syndrome, CRS

Reference materials:https://go.drugbank.com/drugs/DB17256