Dr Gonzalez Velez on the Role of Tarlatamab As Second-Line Treatment For SCLC

"[Tarlatamab] engages the immune system directly, instead of doing cytotoxic damage like traditional chemotherapies that kill the cancer directly. [We] are adding a mechanism of action that boosts or activates the immune system, which hopefully creates a synergistic effect that accumulates and adds to the effects of traditional treatments like chemotherapies or immunotherapies."

Miguel Gonzalez Velez, MD, a medical oncologist at John Theurer Cancer Center at Hackensack University Medical Center, discussed the role of tarlatamab-dlle (Imdelltra) as a second-line treatment for patients small cell lung cancer (SCLC), highlighting data from the primary analysis of the phase 3 DeLLphi-304 study (NCT05740566) presented at the 2025 ASCO Annual Meeting.

The current landscape of SCLC treatment necessitates the development of agents that could drive significant improvements in overall survival (OS), as there has been limited change over the past two decades, Gonzalez Velez began. He explained that novel agents with more targeted and specific mechanisms of action beyond traditional cytotoxic agents are crucial to extending the lives of patients with this aggressive disease, who typically have a median OS of approximately 12 months.

Gonzalez Velez emphasized that tarlatamab represents a new class of agents that directly engage and activate the immune system. Unlike traditional chemotherapies that induce cytotoxic damage, this bispecific T-cell engager can boost the immune response, which may also create a synergistic effect with existing cytotoxic treatments.

Findings from DeLLphi-304 trial demonstrated that the median OS was 13.6 months for tarlatamab (n = 254) vs 8.3 months for chemotherapy (n = 255; HR, 0.60; 95% CI, 0.47-0.77; P < 0.001).

Gonzalez Velez concluded by noting that tarlatamab is well-tolerated, with a lower incidence of high-grade adverse effects and fewer treatment discontinuations compared with chemotherapy. Although safety data showed that tarlatamab was associated with increased rates of dysgeusia, pyrexia, and decreased appetite, an increased incidence of anemia, neutropenia, thrombocytopenia, and decreased platelet counts occurred in the chemotherapy arm.