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195MO Tarlatamab in previously treated small cell lung cancer (SCLC): DeLLphi-300 phase I study long-term outcomes and intracranial activity

H-D. Hummel
; 
S. Champiat
; 
M.E. Olmedo Garcia
; 
M. Boyer
; 
K. He
; 
N. Steeghs
; 
H. Izumi
; 
M.L. Johnson
; 
T. Yoshida
; 
H. Bouchaab
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Journal article
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2024-03-25
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Fox Chase Cancer Center (Temple University)
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https://scholarshare.temple.edu/handle/20.500.12613/11621
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https://doi.org/10.1016/j.esmoop.2024.102768
Abstract
Background Tarlatamab, a bispecific T cell engager (BiTE®) immunotherapy targeting delta-like ligand 3 (DLL3), showed durable antitumor activity and manageable safety in previously treated SCLC. Here we report long-term outcomes and intracranial activity from the DeLLphi-300 phase I study. Methods Tarlatamab was evaluated in patients (pts) with previously treated SCLC. Pts with treated, stable brain metastases were eligible. Primary endpoint was safety. Secondary endpoints included objective response rate (ORR) per mRECIST 1.1 by investigator, duration of response (DOR), progression-free survival (PFS), and overall survival (OS). In retrospective exploratory analyses, CNS tumor sum of diameters (SOD) was assessed per mRANO-BM by BICR in pts with ≥ 1 brain lesion at baseline. This report, with data cutoff (DCO) 14.5 months (mos) beyond Paz-Ares, J Clin Oncol 2023, includes fully enrolled cohorts of pts treated with clinically relevant doses (≥ 10 mg) of tarlatamab. Results 152 pts were treated with tarlatamab ≥ 10 mg (follow-up range 0.2–34.3 mos; median 12.1 mos). Across cohorts, ORR was 25.0% with mDOR of 11.2 mos (table). 25 pts had treatment duration ≥ 52 weeks (range 52–150), including 8 pts treated ≥ 104 weeks. mPFS and mOS were 3.5 mos and 17.5 mos, respectively, with PFS and OS estimates at 12 mos of 16.7% and 57.9%. Of 16 pts with a baseline CNS lesion ≥ 10 mm, CNS tumor SOD decreased ≥ 30% in 10 pts (62.5%). Of 8 pts who completed brain radiotherapy (RT) ≥ 50 days before tarlatamab initiation, 3 pts (37.5%) had ≥ 30% decrease in CNS tumor SOD. No new safety signals were identified. Conclusions In longer follow-up of DeLLphi-300, tarlatamab demonstrated durable responses and unprecedented survival outcomes in previously treated SCLC. While limited to analyses of treated, stable brain metastases, CNS tumor shrinkage following tarlatamab therapy and long after RT supports further study of intracranial efficacy of tarlatamab.
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H-D. Hummel, S. Champiat, M.E. Olmedo Garcia, M. Boyer, K. He, N. Steeghs, H. Izumi, M.L. Johnson, T. Yoshida, H. Bouchaab, A. Dowlati, H. Borghaei, E. Felip, P.J. Jost, S. Gadgeel, X. Chen, Y. Yu, P. Martinez, A. Parkes, L. Paz-Ares, 195MO Tarlatamab in previously treated small cell lung cancer (SCLC): DeLLphi-300 phase I study long-term outcomes and intracranial activity, ESMO Open, Volume 9, Supplement 3, 2024, 102768, ISSN 2059-7029, https://doi.org/10.1016/j.esmoop.2024.102768. (https://www.sciencedirect.com/science/article/pii/S2059702924005362)
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Elsevier
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ESMO Open, Vol. 9
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