
Opinion|Videos|October 18, 2024
Exploring the Mechanisms of Action, Efficacy, Outcomes, and Future Potential of Bispecific T-Cell Engager Therapy in Advanced Small Cell Lung Cancer
Author(s)Ticiana Leal, MD
Ticiana Leal, MD, discusses how tarlatamab, a bispecific T-cell engager (BiTE), leverages the aberrant expression of delta-like ligand 3 on small cell lung cancer (SCLC) cells to direct T-cell-mediated tumor lysis, its promising efficacy shown in the phase 2 DeLLphi-301 study, and the potential clinical benefits of combining it with durvalumab for maintenance therapy after platinum-based chemotherapy.
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Video content above is prompted by the following:
- Please discuss the unique mechanism of action of tarlatamab, a BiTE, and its treatment potential as subsequent therapy for SCLC, which has progressed after platinum-based chemotherapy.
- Please provide your insights on an objective response rate (ORR) of 32% to 40% among participants in the 10 mg and 100 mg groups of the DeLLPhi-301 clinical trial.
- How clinically meaningful is an OR observed between 5 and 7 weeks of tarlatamab initiation?
- What are your views on selecting ORR as the primary
end point in this study? - Regarding the relatively small number of CR and PR responders (n=68) in DeLLphi-301, what is your opinion about the duration of response to tarlatamab at 6 months or longer (59%), at greater than 9 months (29%), and the ongoing response at data cutoff (>50% [n=38]) in the 2 treatment groups?
- What progression-free survival and overall survival end points would you typically expect from second- or third-line therapy in your previously treated patients with relapsed or refractory SCLC?
- In your opinion, what is the future treatment potential of tarlatamab as combination therapy with other anticancer agents for previously treated SCLC that has advanced after 2 or more lines of prior therapy?
- What additional clinical benefits might we anticipate for patients with ES-SCLC by adding tarlatamab to durvalumab as maintenance therapy after primary treatment with platinum-based chemotherapy plus etoposide plus durvalumab?
- What statistically significant trial end points might persuade community oncologists to consider dual maintenance with a bispecific T-cell engager and a PD-L1 inhibitor?
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