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Opinion|Videos|May 15, 2025

Patient Selection Criteria: Identifying Appropriate Candidates for Tarlatamab

Author(s)Samuel Rosner, MD, Ranee Mehra, MD, Michelle Sittig, RN, OCN

Panelists discuss how tarlatamab eligibility is determined based on clinical factors such as prior treatment history, organ function, and ECOG performance status, with particular attention to how previous therapies, such as chimeric antigen receptor T-cell therapy or chemotherapy, may affect eligibility and immune system response.

Episodes in this series

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

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

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

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

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

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

EP. 5 Institutional Implementation: Setting Up Tarlatamab Administration

EP. 5 Institutional Implementation: Setting Up Tarlatamab Administration

EP. 6 Optimizing Multidisciplinary Coordination for Successful Tarlatamab Implementation

EP. 6 Optimizing Multidisciplinary Coordination for Successful Tarlatamab Implementation

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

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

EP. 8 Tarlatamab Administration and Postinfusion Monitoring

EP. 8 Tarlatamab Administration and Postinfusion Monitoring

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

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

EP. 10 Neurological Toxicity Recognition: ICANS Assessment and Management

EP. 10 Neurological Toxicity Recognition: ICANS Assessment and Management

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

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

EP. 12 Nonimmune Adverse Effects: Managing Dysgeusia and Fatigue

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

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

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

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

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

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

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

Summary for Physicians:

Clinical Factors for Tarlatamab Eligibility:

Good candidates:
Relapsed/refractory small cell lung cancer after prior treatments
Adequate organ function (eg, liver, kidney)
ECOG performance status: Typically 0-1 (able to carry out normal activities or minimal assistance needed)
Impact of treatment history:
Chimeric antigen receptor T-cell therapy or bispecifics: May affect eligibility due to prior immune system manipulation; consider potential cross-reactivity or previous toxicities.
Chemotherapy: Previous treatment may influence eligibility, especially if there are complications (eg, neuropathy or compromised organ function).

Prior therapies may also alter immune system response, impacting effectiveness.

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