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.