A new type of immunotherapy is giving hope to people with advanced small cell lung cancer when chemotherapy and other immunotherapies are no longer effective. While not a cure, clinical trials have shown that tarlatamab can help people live longer with fewer side effects. “Tarlatamab has been a significant step forward in treating advanced small cell lung cancer,” says Duke thoracic medical oncologist Cameron Oswalt, MD.
How Tarlatamab Works
Given through an IV in a hospital or an outpatient clinic, tarlatamab is a type of BiTE (bispecific T-cell engager) therapy. BiTE therapy drugs act like bridges between important immune cells called T-cells and tumor cells. They bring these cells together and prompt the T-cells to attack the tumor cells.
“Tarlatamab has been a significant step forward in managing advanced small cell lung cancer."
Side Effects of Tarlatamab
According to Dr. Oswalt, there are two side effects of special interest with tarlatamab. The first is CRS or cytokine release syndrome, which is characterized by fevers, low blood pressure, and trouble breathing. The second is ICANS, or immune effector cell-associated neurotoxicity syndrome. ICANS symptoms can range from mild neurologic changes like confusion to more severe symptoms like lethargy, stupor, and seizures. “Typically, these side effects occur with earlier cycles of tarlatamab,” said Dr. Oswalt. “We have strategies to treat both CRS and ICANS, and that’s why it’s important to watch you in the hospital with the first few treatments -- if either happens, we want to be able to act quickly.”
Seek Out a Cancer Center with Expertise in Administering Tarlatamab
According to Dr. Oswalt, tarlatamab “requires expertise to administer properly and to handle potential side effects. Here at Duke, we’ve treated a large number of patients with the therapy, and we are very familiar with the treatment and with what it takes to manage side effects.” Dr. Oswalt added that Duke was also involved in early tarlatamab clinical trials and continues to conduct research into the drug and its side effects.
It’s also important to receive treatment at a center with a team-based approach. In addition to oncologists, Duke providers include nurses trained in protocols for how to manage side effects, pharmacists who dose supportive medications, and administrative and financial staff to make sure insurance covers the treatment.
