Tarlatamab in small cell lung cancer following platinum-based chemotherapy: subgroup analysis of Japanese patients from the DeLLphi-304 study.
Takayasu Kurata, Shunichi Sugawara, Hiroaki Akamatsu et al.
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In 30 seconds
This randomized Phase III subgroup analysis evaluated tarlatamab versus amrubicin in Japanese patients with small-cell lung cancer progressing after platinum-based chemotherapy. By the 29 January 2025 data cutoff, 35 patients had been enrolled. Median overall survival was not reached with tarlatamab and was 11.5 months with amrubicin (HR 0.533 [95% CI, 0.186–1.529]); response and duration-of-response results also numerically favored tarlatamab. Grade ≥3 treatment-related adverse events occurred in 8.3% versus 56.5%, respectively. The authors considered the findings consistent with those in the global population.
Key findings
- Median overall survival was not reached with tarlatamab versus 11.5 months with amrubicin (HR [95% CI] = 0.533 [0.186, 1.529]).
- Objective response rates were 33.3% with tarlatamab and 26.1% with amrubicin; median duration of response was 10.1 versus 5.6 months.
- Grade ≥ 3 treatment-related adverse events occurred in 8.3% of tarlatamab-treated patients versus 56.5% with amrubicin.
- Cytokine release syndrome occurred in 75% of tarlatamab-treated patients; all cases were grade 1 or 2, and one patient had grade 2 neurotoxicity.
Why it matters
The Japanese subgroup provides population-specific efficacy and safety data for tarlatamab after platinum-based chemotherapy. Its numerically favorable survival and response outcomes, alongside fewer high-grade treatment-related adverse events than amrubicin, are clinically relevant signals, while the small subgroup and imprecise survival estimate mean the results should be interpreted cautiously.
What to keep in mind
The Japanese subgroup was small (35 patients, including 12 assigned to tarlatamab), and the overall-survival confidence interval was wide and included no difference.