Tarlatamab in Small-Cell Lung Cancer after Platinum-Based Chemotherapy Journal Article
| Authors: | Mountzios, G.; Sun, L.; Cho, B. C.; Demirci, U.; Baka, S.; Gümüş, M.; Lugini, A.; Zhu, B.; Yu, Y.; Korantzis, I. |
| Article Title: | Tarlatamab in Small-Cell Lung Cancer after Platinum-Based Chemotherapy |
| Abstract: | Background Tarlatamab, a bispecific delta-like ligand 3-directed T-cell engager immunotherapy, received accelerated approval for the treatment of patients with previously treated small-cell lung cancer. Whether tarlatamab is more effective than chemotherapy in the treatment of patients whose small-cell lung cancer has progressed during or after initial platinum-based chemotherapy is not known. Methods We conducted a multinational, phase 3, open-label trial to compare tarlatamab with chemotherapy as second-line treatment in patients with small-cell lung cancer whose disease had progressed during or after platinum-based chemotherapy. Patients were randomly assigned to receive tarlatamab or chemotherapy (topotecan, lurbinectedin, or amrubicin). The primary end point was overall survival. Key secondary end points were investigator-assessed progression-free survival and patient-reported outcomes. Results of the prespecified interim analysis (data-cutoff date, January 29, 2025) are reported. Results A total of 509 patients were randomly assigned to receive tarlatamab (254 patients) or chemotherapy (255 patients). Treatment with tarlatamab resulted in significantly longer overall survival than chemotherapy (median, 13.6 months [95% confidence interval {CI}, 11.1 to not reached] vs. 8.3 months [95% CI, 7.0 to 10.2]; stratified hazard ratio for death, 0.60; 95% CI, 0.47 to 0.77; P<0.001). Tarlatamab treatment also had a significant benefit with respect to progression-free survival and cancer-related dyspnea and cough as compared with chemotherapy. The incidence of adverse events of grade 3 or higher was lower with tarlatamab than with chemotherapy (54% vs. 80%), as was the incidence of adverse events resulting in treatment discontinuation (5% vs. 12%). Conclusions Treatment with tarlatamab led to longer overall survival than chemotherapy among patients with small-cell lung cancer whose disease had progressed during or after platinum-based chemotherapy. © 2025 Elsevier B.V., All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; overall survival; clinical trial; mortality; antineoplastic agents; comparative study; chemotherapy; topotecan; antineoplastic agent; progression free survival; randomized controlled trial; antineoplastic combined chemotherapy protocols; lung neoplasms; lung cancer; coughing; dyspnea; lung tumor; thorax pain; multicenter study; brain metastasis; phase 3 clinical trial; drug therapy; anthracycline; anthracyclines; fused heterocyclic rings; small cell lung cancer; small cell lung carcinoma; platinum-based chemotherapy; progression-free survival; patient-reported outcome; antibodies, bispecific; hematology/oncology; bispecific antibody; amrubicin; carbolines; very elderly; humans; human; male; female; article; carboline derivative; lurbinectedin; heterocyclic compounds, 4 or more rings; treatments in oncology; amg 757; tarlatamab; pulmonary/critical care; pulmonary/critical care general; pm 01183 |
| Journal Title: | New England Journal of Medicine |
| Volume: | 393 |
| Issue: | 4 |
| ISSN: | 15334406 |
| Publisher: | Elsevier B.V. |
| Date Published: | 2025-01-01 |
| Start Page: | 349 |
| End Page: | 361 |
| Language: | English |
| DOI: | 10.1056/NEJMoa2502099 |
| PUBMED: | 40454646 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work