Breakthrough Treatment for Small Cell Lung Cancer: New Therapy Offers Hope for Advanced-Stage Patients
New Frontiers in Small Cell Lung Cancer Treatment at Moffitt Cancer Center – First in U.S. to Treat Patients with New T Cell Therapy Tarlatamab
At Moffitt, we are dedicated to advancing the treatment of small cell lung cancer (SCLC), a highly aggressive and rapidly progressing form of lung cancer. SCLC is characterized by its distinct histology, marked by small, round cells that grow quickly and tend to metastasize early.
Accounting for approximately 10-15% of all lung cancers, SCLC is often associated with a prior history of smoking and has a poorer prognosis compared to non-small cell lung cancer. SCLC is typically diagnosed at an advanced stage due to its aggressive nature, with patients frequently presenting with extensive-stage disease. Despite significant advancements in diagnosis and therapy, the prognosis for SCLC patients remains challenging, with a median survival time of two to four months without treatment and a five-year overall survival rate of only 12%.
The management of SCLC often involves a combination of chemotherapy and immunotherapy, which can initially be effective but is frequently followed by relapse. The rapid development of resistance to traditional treatments necessitates the need for new, more efficacious therapeutic options. At Moffitt, we are at the forefront of exploring innovative treatment options, including the recent introduction of tarlatamab therapy, aimed at improving outcomes for our SCLC patient
Tarlatamab Therapy: What is It?
We are proud to be the first institution in the United States to offer tarlatamab as a standard treatment for patients with extensive-stage SCLC. Tarlatamab, developed by Amgen®, is a bispecific T-cell engager (BiTE®) therapy designed to harness the body's immune system to target cancer cells more precisely. The molecule features dual specificities: one arm binds to CD3, a component of the T-cell receptor complex on cytotoxic T cells, while the other binds to delta-like ligand 3 (DLL3), a protein expressed on the surface of SCLC cells but is rarely found in other tissues.
The dual action of tarlatamab brings T cells into close proximity with SLCC cells that reside in a highly immunosuppressive tumor microenvironment, facilitating the release of cytotoxic granules that induce apoptosis in the target cells. The choice of DLL3 as a target is particularly strategic, as its high expression in SCLC makes it a suitable marker for the selective targeting of malignant cells. This specificity helps minimize off-target effects and mitigate potential damage to normal tissues.
Moffitt Cancer Center played an important role in the phase 2 clinical trial that evaluated tarlatamab's efficacy and safety. The trial included patients with extensive-stage SCLC who had previously received standard therapies, making them a particularly challenging cohort. Despite these challenges, the trial demonstrated a notable objective response rate, with a significant proportion of patients achieving partial or complete tumor regression. This trial's results were published in The New England Journal of Medicine, highlighting the therapy's potential to induce durable responses even in heavily pretreated patients.
The study also found a manageable safety profile of tarlatamab, with the most common adverse events being cytokine release syndrome (CRS) and neurotoxicity. CRS, a well-known risk with T-cell therapies, involves a systemic inflammatory response that can range from mild to severe. At Moffitt, we have established protocols to promptly identify and manage CRS and other potential side effects, ensuring patient safety during and after treatment.
The FDA's accelerated approval of tarlatamab for second-line treatment was based on these promising clinical results, providing a new option for patients who have limited alternatives after standard therapies have failed to provide satisfactory results. Since the drug's approval, we have treated more than 15 patients with observed significant clinical benefits to date.
Impact on Treatment and Patient Care
Tarlatamab represents a significant advancement in the treatment landscape for extensive-stage SCLC. The therapy has shown promising efficacy, with several patients achieving partial or complete responses in clinical trials. This new treatment option has been particularly valuable for patients who have limited alternatives after standard therapies.
We are equipped to manage the unique challenges associated with administering tarlatamab. Our team is skilled in handling potential side effects, such as cytokine release syndrome and neurotoxicity, ensuring that patients receive comprehensive care. We also prioritize patient education, providing detailed information about the therapy and its potential outcomes to help patients and their families make informed decisions.
Ongoing Research and Future Directions
Our commitment to improving SCLC treatment extends beyond the introduction of new therapies like tarlatamab. Here at Moffitt, we are continuously engaged in research efforts to better understand the biology of SCLC and identify novel therapeutic targets. Our research is focused on developing personalized treatment strategies that can improve outcomes for our patients.
Our multidisciplinary teams are dedicated to providing comprehensive cancer care, from diagnosis to treatment and beyond. We are equipped with state-of-the-art facilities and a robust infrastructure for clinical trials, making us a leader in innovative cancer therapies. Our vision is to transform cancer care through pioneering research, personalized treatment, and community outreach.
We believe that advancing the understanding and treatment of cancer requires a collaborative effort. We are proud to be a part of the global fight against cancer and remain dedicated to improving the lives of patients through cutting-edge research and compassionate care. Our goal is to continue pushing the boundaries of what's possible in oncology, making a difference in the lives of those we serve.
If you’d like to refer a patient to Moffitt, complete our online form or contact a physician liaison for assistance. As part of our efforts to shorten referral times as much as possible, online referrals are normally responded to within 24 - 48 hours.
References and Further Reading
- Ahn M-J, Cho BC, Felip E, et al for the DeLLphi-301 Investigators. Tarlatamab for Patients with Previously Treated Small-Cell Lung Cancer. N Engl J Med. 2023; 389: 2063-2075.
- Moffitt is First in U.S. to Offer New Lung Cancer Therapy. Moffitt Cancer Center
- S. Food and Drug Administration. FDA Grants Accelerated Approval to Tarlatamab-dlle for Extensive Stage Small Cell Lung Cancer. Press Release.
Learn more about Moffitt Cancer Center, our lung cancer treatment program, and our use of the newly approved tarlatamab.