Complex ES-SCLC Case: Tarlatamab Management Through Toxicity to Clinical Benefit

EP: 1.ES-SCLC vs LS-SCLC: Critical Differences in Disease Burden and Patient Prognosis

EP: 2.Current Treatment Paradigm: Evolution of First-Line Therapy for ES-SCLC

EP: 3.Addressing Critical Unmet Needs in ES-SCLC Patient Management

EP: 4.Emerging Clinical Trials: Novel Approaches in Second-Line ES-SCLC

EP: 5.Institutional Implementation: Setting Up Tarlatamab Administration

EP: 6.Optimizing Multidisciplinary Coordination for Successful Tarlatamab Implementation

EP: 7.Patient Selection Criteria: Identifying Appropriate Candidates for Tarlatamab

EP: 8.Tarlatamab Administration and Postinfusion Monitoring

EP: 9.Essential Patient and Caregiver Education for Tarlatamab Treatment Success

EP: 10.Neurological Toxicity Recognition: ICANS Assessment and Management

EP: 11.CRS Recognition and Intervention: Timing and Clinical Features

EP: 12.Nonimmune Adverse Effects: Managing Dysgeusia and Fatigue

EP: 13.Differential Toxicity Profile: Tarlatamab vs Traditional Cytotoxic Therapies

EP: 14.Standardized Toxicity Grading: Institutional Protocols for CRS and ICANS

EP: 15.Future Research Priorities: Optimizing Tarlatamab Administration and Toxicity Management

EP: 16.Seamless Transitions: Managing the Inpatient to Outpatient Care Continuum

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EP: 17.Complex ES-SCLC Case: Tarlatamab Management Through Toxicity to Clinical Benefit

Summary for Physicians:

Complex Extensive-Stage Small Cell Lung Cancer Case: Tarlatamab Management Through Toxicity to Clinical Benefit

• Initial phase:
• Close inpatient monitoring during early cycles due to risk of cytokine release syndrome (CRS) and immune effector cell –associated neurotoxicity syndrome (ICANS).

• Gradual dose escalation may be used to improve tolerance.
• Toxicity management:
• Prompt recognition and management of grade 1 to 2 CRS with supportive care; grade 3 or greater may require tocilizumab and steroids.

• Neurotoxicity (ICANS) managed with neurology consults, steroids, and intensive care unit–level support if severe.
• Clinical benefit:
• Despite early toxicities, patients may achieve meaningful responses with tumor reduction and symptom improvement.

• Ongoing benefit often seen with continued outpatient infusions and proactive monitoring.

Key Takeaway:

• Effective toxicity management can allow patients to continue therapy and derive clinical benefit, even in high-risk or heavily pretreated cases.