Advancing SCLC Care: Tarlatamab as a Promising First-Line Option


Ariel Lopez-Chavez, MD, discusses the potential of tarlatamab and its use in the frontline setting for the treatment of patients with small cell lung cancer.

Ariel Lopez-Chavez, MD, medical oncologist, director of precision medicine and developmental therapeutics at Allegheny Health Network Cancer Institute, discusses the potential of tarlatamab (AMG 757) and its use in the frontline setting for the treatment of patients with small cell lung cancer (SCLC).

According to Lopez-Chavez, investigators have a heavy focus on assessing PD-L1 therapy in the frontline setting, as well as combining agents to enhance efficacy. Some of these include combining carboplatin or cisplatin with etoposide and atezolizumab (Tecentriq) or durvalumab (Imfinzi) followed by maintenance therapy. Each of these are FDA-approved options in the frontline setting. In the second-line lurbinectedin (Zepzelca) and topotecan can be used.

Notably, Lopez-Chavez is interested in learning more about tarlatamab, an antibody-drug conjugate, which has shown impressive results in patients with refractory SCLC. The FDA granted accelerated approval to tarlatamab on May 16, 2024, for the treatment of patients with SCLC that has progressed on or after platinum-based chemotherapy, making it the first BiTE approved for a major solid tumor and the first therapeutic option for the treatment of extensive-stage SCLC.


0:09 | I am excited about tarlatamab, which is an antibody-drug conjugate. The specific molecule that is targeting the delta-like ligand 3 and CD3, which is highly expressed in small cell lung cancer. That makes it an attractive target in small cell lung cancer. We already have data for our phase 1 study with tarlatamab for refractory small cell lung cancer. Here, we saw impressive results. We have an overall response rate of 23%, a median [progression-free survival (PFS)] of 3.7 months, that is not that impressive, but then the thing that was really impressive was the median overall survival of 13.2 months.

1:11 | That is something that is very impressive because, just to put that into context, the median overall survival in the frontline setting for atezolizumab and durvalumab was between 12 and 13 months. Here, we are seeing that tarlatamab in the second-line setting is 13.2 months. The [adverse] effects [and] the safety profile [are] manageable. We do not have as much myelosuppression as we see with topotecan or lurbinectedin. This is an attractive agent. Now it is being brought to the frontline setting and being studied during the frontline setting. I am excited about that combination [and] I think that is something to be looking out for.

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