OncLive Fellows Forum Spotlights New Data for Tarlatamab in SCLC and PRO Results in Hospitalized Patients

Findings from a real-world study of tarlatamab-dlle (Imdelltra) in patients with relapsed/refractory small cell lung cancer (SCLC) with untreated brain metastases could inform future use of the agent beyond the patient population that the agent was initially evaluated in, according to Kelsey Pan, MD, MPH. Additionally, data from a prospective study of patient-reported outcomes (PROs) in hospitalized patients with cancer have the potential to inform the design of future clinical trials, she added.

During the OncLive Fellows Forum on Thoracic Oncology, which took place during the 2025 ASCO Annual Meeting, findings from a retrospective study of tarlatamab conducted at the University of Virginia were presented.1 At a median follow-up of 6.7 months, data from the study showed that patients with SCLC (n = 21) experienced an overall response rate of 42.9% and a median progression-free survival (PFS) of 2.7 months. Notably, brain metastases were reported in 40.9% of patients.

In another presentation from the meeting, Noha Soror, MD, a hematology/oncology fellow at the University of Oklahoma College of Medicine in Oklahoma City, presented data from a prospective study which demonstrated that age (P < .01) and female sex (P < .01) were associated with greater symptom severity by MD Anderson Symptom Inventory interference scores among hospitalized patients with cancer.2 Additionally, older individuals were found to be more likely to use religion (P = .01), humor (P < .01), and emotional support (P = .03) as coping mechanisms. Female patients used self-distraction as a coping mechanism more often compared with male patients (P < .01).

“In thoracic oncology, we as fellows are very fortunate to have a lot of opportunities [including] conferences and these OncLive events before national meetings where we can connect with other fellows,” Pan said in an interview with OncLive®. “I have been attending thoracic conferences since my first year of fellowship and through these extracurricular events, I have been able to meet a lot of thoracic oncology fellows throughout the nation. It’s nice to connect with peers who will become our future colleagues and potential collaborators on research.”

Pan is a thoracic medical oncologist at Emory Winship Cancer Institute and an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine in Atlanta, Georgia.

In the interview, Pan highlighted presentations of interest from the meeting, including the role of MTAP deletions in patients with non–small cell lung cancer (NSCLC), the use of tarlatamab in patients with SCLC with brain metastases, and PROs in hospitalized patients with cancer.

OncLive: What are your primary takeaways from the presentation that examined MTAP deletions in NSCLC?

Pan: I was privileged to be able to participate in the OncLive Fellows Forum on Thoracic Oncology, where various fellows from different institutions presented their research. In my group, we had Jessica Ross, MD, from Memorial Sloan Kettering Cancer Center, and she presented their institutional project on MTAP deletions in [patients with] NSCLC. It’s an exciting project because MTAP deletions are an emerging therapeutic target which occur in approximately 10% of lung adenocarcinomas.

[The study authors] found that MTAP deletions often co-occur with other [alterations in] driver oncogenes such as [those in] EGFR and ALK. In their institutional experience, approximately 80% of patients with [disease harboring] MTAP deletions [experienced] these co-occurring [alterations in] other oncogene drivers. This is an area of early research with lots of emerging therapies and early clinical trials, and I look forward to seeing the outcomes of those.

It was news to all of us, even some of the faculty members, how frequently MTAP deletions occur with other driver oncogene [alterations] because I don’t believe that’s been previously found. We expected MTAP deletions to occur more in the nondriver oncogene population. This [finding] raises a lot of questions and [could inform] future directions in terms of how to sequence MTAP inhibitors with other targeted therapies such as EGFR and ALK inhibitors.

What were the highlights from the presentation on the real-world outcomes of tarlatamab in SCLC, including in those with active brain metastases?

[This presentation examined] the real-world experience with tarlatamabin patients who were previously excluded from the original [phase 2] DeLLphi-301 trial [NCT05060016]. [This real-world study] included patients with active brain metastases and other exclusion criteria [of DeLLphi-301] and evaluated the rates of toxicities such as cytokine release syndrome [CRS] and immune effector cell–associated neurotoxicity syndrome [ICANS].

[The study authors] found that patients with active brain metastases and other exclusion criteria had higher rates of CRS and ICANS. They also highlighted some of the central nervous system outcomes, such as PFS, both intracranially and extracranially, and those were interesting because they were also not evaluated in the original trial. Now that tarlatamab is approved [by the FDA] for patients with SCLC [with disease progression on or after platinum-based chemotherapy],3 it was informative for me to learn how those who were not the classic trial patients did on this agent.

How should PROs be used to inform clinical trial design?

PROs are [often] underrepresented in a lot of the pivotal clinical trials. That’s something being increasingly discussed thanks to patient advocates such as Jill Feldman. A lot of times we think about extending PFS, overall survival, and [other] numerical outcomes, when a lot of aspects that affect quality of life for patients are different than what we traditionally measure. It’s very important to include some of these standardized PRO measures in future clinical trials.

References

1. Bolte FJ, Dougherty SC, Danos AO, et al. Real-world outcomes of tarlatamab in small cell lung cancer, including patients with untreated brain metastases. Clin Lung Cancer. 2025;26(5):347-353.e1. doi:10.1016/j.cllc.2025.03.006
2. Soror N, Lam AB, Arepalli SSVL, et al. Factors associated with patient-reported outcomes in hospitalized patients with cancer. J Clin Oncol. 2025;43(suppl 16):11116. doi:10.1200/JCO.2025.43.16_suppl.11116
3. FDA grants accelerated approval to tarlatamab-dlle for extensive stage small cell lung cancer. FDA. May 16, 2024. Accessed September 10, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-tarlatamab-dlle-extensive-stage-small-cell-lung-cancer