2025 Hot Topic in Basic & Translational Science: Small Cell Lung Cancer - Posters-PP01.19: Real World Safety of Tarlatamab Step-Up Dosing in Extensive Stage Small Cell Lung Cancer

PP01.19: Real World Safety of Tarlatamab Step-Up Dosing in Extensive Stage Small Cell Lung Cancer

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The H. Lee Moffitt Cancer Center conducted a real-world study on the safety of Tarlatamab, a bispecific T-cell engager approved for treating recurrent or relapsed extensive-stage small cell lung cancer (SCLC). This study followed 31 patients from May to November 2024, assessing the incidence of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), focusing on grades, timing, and rates of prolonged hospitalization or readmission.<br /><br />Tarlatamab treatment in the initial patient cohort resulted in severe adverse events, with three instances of CRS/ICANS leading to mortality or hospice care. As a response, prophylactic Tocilizumab (pToci) was implemented to moderate high-risk patients, characterized by factors like advanced age, comorbidities, and elevated inflammatory markers. <br /><br />Outcomes showed that CRS and ICANS occurred most frequently after the initial C1D1 dose, with 55.5% experiencing CRS and 22.2% experiencing ICANS at varying grades. Notably, the timing of symptom onset was around 11 hours for CRS and 12 hours for ICANS. For patients receiving prophylactic Tocilizumab, only one recorded a Grade 2 ICANS during C1D8, and no CRS events were observed throughout the cycle.<br /><br />In summary, the prophylactic use of Tocilizumab showed potential in reducing CRS and ICANS risks, particularly in patients with identifiable high-risk profiles. The study highlights the necessity for vigilant monitoring and potential prophylactic interventions in managing Tarlatamab treatment outcomes in SCLC.

Asset Subtitle

Sonam Puri

Keywords

Tarlatamab

bispecific T-cell engager

small cell lung cancer

cytokine release syndrome

immune effector cell-associated neurotoxicity syndrome

prophylactic Tocilizumab

adverse events

real-world study

high-risk patients

treatment outcomes