Imdelltra (tarlatamab-dlle)

P1, N=82, Recruiting, Amgen | N=34 --> 82

P1, N=200, Suspended, Amgen | Recruiting --> Suspended

Following three months of maintenance therapy with atezolizumab, new metastatic lesions in the liver and brain developed. Tarlatamab induced complete resolution of the metastatic lesions in the liver and brain, without adverse events attributable to tarlatamab. This case underscores the potential value of delta-like ligand 3-targeted therapy with tarlatamab in metastatic digestive neuroendocrine carcinoma, a rare and highly aggressive malignancy with few effective treatment options.

Acquired resistance to tarlatamab plus anti-PD-1 in SCLC was associated with low DLL3 antigen expression particularly in the setting of phenotypic switch to a non-small cell lung cancer morphology and an increasingly immunosuppressive TME. Therefore, combination strategies that incorporate immune checkpoint blockade or myeloid-targeted therapies may be warranted to enhance treatment outcomes.

In this case, the peripheral blood lymphocyte count decreased, and the interleukin-6 level was markedly elevated, which was thought to reflect T-cell accumulation in the tumor. These trends in the blood tests may be useful in easily differentiating PsPD from true progressive disease during tarlatamab treatment.

P1/2, N=57, Recruiting, AIO-Studien gGmbH | Not yet recruiting --> Recruiting

P=N/A, N=25, Not yet recruiting, Duke University

P2, N=92, Active, not recruiting, Amgen | N=69 --> 92

P2, N=252, Active, not recruiting, Amgen | Recruiting --> Active, not recruiting

Concurrent radiotherapy with tarlatamab is safe, with low severe toxicity, frequent local tumor response, and a trend toward improved OS, supporting further study in ES-SCLC.

By sharing insights into administration protocols, dose ramp-up procedures, post-cycle 1 monitoring, and AE management strategies implemented at their centres, early adopters of tarlatamab can help other institutions develop and refine their own protocols more efficiently. Lessons learned during the early implementation phase, including the roles of various healthcare providers and the transition from inpatient to outpatient care, should facilitate the smoother integration of tarlatamab and other TCEs for solid tumours into clinical pathways across Canada.

P1/2, N=40, Recruiting, Institut Gustave Roussy