Practical management of adverse events in patients receiving tarlatamab, a delta-like ligand 3–targeted bispecific T-cell engager immunotherapy, for previously treated small cell lung cancer Review
| Authors: | Sands, J. M.; Champiat, S.; Hummel, H. D.; Paulson, K. G.; Borghaei, H.; Alvarez, J. B.; Carbone, D. P.; Carlisle, J. W.; Choudhury, N. J.; Clarke, J. M.; Gadgeel, S. M.; Izumi, H.; Navarro, A.; Lau, S. C. M.; Lammers, P. E.; Huang, S.; Hamidi, A.; Mukherjee, S.; Owonikoko, T. K. |
| Review Title: | Practical management of adverse events in patients receiving tarlatamab, a delta-like ligand 3–targeted bispecific T-cell engager immunotherapy, for previously treated small cell lung cancer |
| Abstract: | Tarlatamab is a bispecific T-cell engager immunotherapy targeting delta-like ligand 3 (DLL3) and the cluster of differentiation 3 (CD3) molecule. In the phase 2 DeLLphi-301 trial of tarlatamab for patients with previously treated small cell lung cancer, tarlatamab 10 mg every 2 weeks achieved durable responses and encouraging survival outcomes. Analyses of updated safety data from the DeLLphi-301 trial demonstrated that the most common treatment-emergent adverse events were cytokine release syndrome (53%), pyrexia (38%), decreased appetite (36%), dysgeusia (32%), and an emia (30%). Cytokine release syndrome was mostly grade 1 or 2 in severity, occurred primarily after the first or second tarlatamab dose, and was managed with supportive care, which included the administration of antipyretics (e.g., acetaminophen), intravenous hydration, and/or glucocorticoids. Other treatment-emergent adverse effects of interest included neutropenia (16%) and immune effector cell-associated neurotoxicity syndrome and associated neurologic events (10%). Given that tarlatamab is the first T-cell engager approved for the treatment of small cell lung cancer, raising awareness with regard to the monitoring and management of tarlatamab-associated adverse events is essential. Here, the authors describe the timing, occurrence, and duration of these adverse events and review the management and risk-mitigation strategies used by clinical investigators during the DeLLphi-301 trial. © 2025 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society. |
| Keywords: | adult; controlled study; neutropenia; review; side effect; neurotoxicity; cd3 antigen; t lymphocyte; t-lymphocytes; phase 2 clinical trial; randomized controlled trial; lung neoplasms; membrane proteins; cell differentiation; drug effect; fever; lung tumor; immunology; immunotherapy; multicenter study; membrane protein; glucocorticoid; drug therapy; adverse drug reaction; therapy; dysgeusia; small cell lung cancer; small cell lung carcinoma; adverse event; decreased appetite; cytokine release syndrome; procedures; antibodies, bispecific; antipyretic agent; bispecific antibody; safety profile; humans; human; male; female; adverse event management; tarlatamab; dellphi-301 |
| Journal Title: | Cancer |
| Volume: | 131 |
| Issue: | 3 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2025-02-01 |
| Start Page: | e35738 |
| Language: | English |
| DOI: | 10.1002/cncr.35738 |
| PUBMED: | 39876075 |
| PROVIDER: | scopus |
| PMCID: | PMC11775405 |
| DOI/URL: | |
| Notes: | Review -- Source: Scopus |
