Tarlatamab for Patients with Previously Treated Small-Cell Lung Cancer.
Humans
Antineoplastic Agents
/ administration & dosage
Carcinoma, Non-Small-Cell Lung
/ drug therapy
Cytokines
Lung Neoplasms
/ drug therapy
Small Cell Lung Carcinoma
/ drug therapy
Antineoplastic Agents, Immunological
/ administration & dosage
Administration, Intravenous
Cytokine Release Syndrome
/ chemically induced
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
30 Nov 2023
30 Nov 2023
Historique:
medline:
5
12
2023
pubmed:
20
10
2023
entrez:
20
10
2023
Statut:
ppublish
Résumé
Tarlatamab, a bispecific T-cell engager immunotherapy targeting delta-like ligand 3 and CD3, showed promising antitumor activity in a phase 1 trial in patients with previously treated small-cell lung cancer. In this phase 2 trial, we evaluated the antitumor activity and safety of tarlatamab, administered intravenously every 2 weeks at a dose of 10 mg or 100 mg, in patients with previously treated small-cell lung cancer. The primary end point was objective response (complete or partial response), as assessed by blinded independent central review according to the Response Evaluation Criteria in Solid Tumors, version 1.1. Overall, 220 patients received tarlatamab; patients had previously received a median of two lines of treatment. Among patients evaluated for antitumor activity and survival, the median follow-up was 10.6 months in the 10-mg group and 10.3 months in the 100-mg group. An objective response occurred in 40% (97.5% confidence interval [CI], 29 to 52) of the patients in the 10-mg group and in 32% (97.5% CI, 21 to 44) of those in the 100-mg group. Among patients with an objective response, the duration of response was at least 6 months in 59% (40 of 68 patients). Objective responses at the time of data cutoff were ongoing in 22 of 40 patients (55%) in the 10-mg group and in 16 of 28 patients (57%) in the 100-mg group. The median progression-free survival was 4.9 months (95% CI, 2.9 to 6.7) in the 10-mg group and 3.9 months (95% CI, 2.6 to 4.4) in the 100-mg group; the estimates of overall survival at 9 months were 68% and 66% of patients, respectively. The most common adverse events were cytokine-release syndrome (in 51% of the patients in the 10-mg group and in 61% of those in the 100-mg group), decreased appetite (in 29% and 44%, respectively), and pyrexia (in 35% and 33%). Cytokine-release syndrome occurred primarily during treatment cycle 1, and events in most of the patients were grade 1 or 2 in severity. Grade 3 cytokine-release syndrome occurred less frequently in the 10-mg group (in 1% of the patients) than in the 100-mg group (in 6%). A low percentage of patients (3%) discontinued tarlatamab because of treatment-related adverse events. Tarlatamab, administered as a 10-mg dose every 2 weeks, showed antitumor activity with durable objective responses and promising survival outcomes in patients with previously treated small-cell lung cancer. No new safety signals were identified. (Funded by Amgen; DeLLphi-301 ClinicalTrials.gov number, NCT05060016.).
Sections du résumé
BACKGROUND
BACKGROUND
Tarlatamab, a bispecific T-cell engager immunotherapy targeting delta-like ligand 3 and CD3, showed promising antitumor activity in a phase 1 trial in patients with previously treated small-cell lung cancer.
METHODS
METHODS
In this phase 2 trial, we evaluated the antitumor activity and safety of tarlatamab, administered intravenously every 2 weeks at a dose of 10 mg or 100 mg, in patients with previously treated small-cell lung cancer. The primary end point was objective response (complete or partial response), as assessed by blinded independent central review according to the Response Evaluation Criteria in Solid Tumors, version 1.1.
RESULTS
RESULTS
Overall, 220 patients received tarlatamab; patients had previously received a median of two lines of treatment. Among patients evaluated for antitumor activity and survival, the median follow-up was 10.6 months in the 10-mg group and 10.3 months in the 100-mg group. An objective response occurred in 40% (97.5% confidence interval [CI], 29 to 52) of the patients in the 10-mg group and in 32% (97.5% CI, 21 to 44) of those in the 100-mg group. Among patients with an objective response, the duration of response was at least 6 months in 59% (40 of 68 patients). Objective responses at the time of data cutoff were ongoing in 22 of 40 patients (55%) in the 10-mg group and in 16 of 28 patients (57%) in the 100-mg group. The median progression-free survival was 4.9 months (95% CI, 2.9 to 6.7) in the 10-mg group and 3.9 months (95% CI, 2.6 to 4.4) in the 100-mg group; the estimates of overall survival at 9 months were 68% and 66% of patients, respectively. The most common adverse events were cytokine-release syndrome (in 51% of the patients in the 10-mg group and in 61% of those in the 100-mg group), decreased appetite (in 29% and 44%, respectively), and pyrexia (in 35% and 33%). Cytokine-release syndrome occurred primarily during treatment cycle 1, and events in most of the patients were grade 1 or 2 in severity. Grade 3 cytokine-release syndrome occurred less frequently in the 10-mg group (in 1% of the patients) than in the 100-mg group (in 6%). A low percentage of patients (3%) discontinued tarlatamab because of treatment-related adverse events.
CONCLUSIONS
CONCLUSIONS
Tarlatamab, administered as a 10-mg dose every 2 weeks, showed antitumor activity with durable objective responses and promising survival outcomes in patients with previously treated small-cell lung cancer. No new safety signals were identified. (Funded by Amgen; DeLLphi-301 ClinicalTrials.gov number, NCT05060016.).
Identifiants
pubmed: 37861218
doi: 10.1056/NEJMoa2307980
doi:
Substances chimiques
Antineoplastic Agents
0
Cytokines
0
Antineoplastic Agents, Immunological
0
Banques de données
ClinicalTrials.gov
['NCT05060016']
Types de publication
Clinical Trial, Phase II
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2063-2075Investigateurs
Richard Greil
(R)
Sabin Handzhiev
(S)
Kristiaan Nackaerts
(K)
Karim Vermaelen
(K)
Seppo Langer
(S)
Sebastien Couraud
(S)
Laurent Greillier
(L)
Pauline Du Rusquec
(P)
Horst-Dieter Hummel
(HD)
Martin Reck
(M)
Jürgen Wolf
(J)
Sofia Agelaki
(S)
George Fountzilas
(G)
Ippokratis Korantzis
(I)
Giannis Mountzios
(G)
Federico Cappuzzo
(F)
Marcello Tiseo
(M)
Hiroaki Akamatsu
(H)
Hidetoshi Hayashi
(H)
Yoshitsugu Horio
(Y)
Hiroki Izumi
(H)
Satoru Kitazono
(S)
Kadoaki Ohashi
(K)
Kazushige Wakuda
(K)
Myung-Ju Ahn
(MJ)
Byoung Chul Cho
(BC)
Ji-Youn Han
(JY)
Sang-We Kim
(SW)
Jong-Seok Lee
(JS)
Anne-Marie Dingemans
(AM)
Rafal Dziadziuszko
(R)
Barbara Parente
(B)
João Moreira Pinto
(J)
Encarnação Teixeira
(E)
Noemi Reguart Aransay
(N)
Maria Vanesa Gutierrez Calderon
(MV)
Enriqueta Felip
(E)
Luis Paz-Ares
(L)
Mariano Provencio Pulla
(M)
Margarita Majem
(M)
Oscar Juan-Vidal
(O)
Alfredo Addeo
(A)
Hsu-Ching Huang
(HC)
Fiona Blackhall
(F)
Elisa Fontana
(E)
Jean Bustamante Alvarez
(J)
Konstantinos Arnaoutakis
(K)
Hossein Borghaei
(H)
Jeffrey Clarke
(J)
Afshin Dowlati
(A)
Muhammad Furqan
(M)
Melissa Johnson
(M)
Taofeek Owonikoko
(T)
William Petty
(W)
Suresh Ramalingam
(S)
Jacob Sands
(J)
Patrick Ward
(P)
Informations de copyright
Copyright © 2023 Massachusetts Medical Society.