Standardized Toxicity Grading: Institutional Protocols for CRS and ICANS

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

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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

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

Summary for Physicians:

Standardized Toxicity Grading: Cytokine Release Syndrome (CRS) and Immune Effector Cell–Associated Neurotoxicity Syndrome (ICANS)

• CRS:
• Grade 1: Fever, mild symptoms, manageable with supportive care

• Grade 2: Moderate symptoms (eg, hypotension, hypoxia), requires intervention (eg, intravenous fluids, antipyretics)

• Grade 3: Severe symptoms (eg, multiorgan involvement), requires corticosteroids and tocilizumab

• Grade 4: Life-threatening, requires intensive care unit (ICU) care and urgent interventions
• ICANS:
• Grade 1: Mild symptoms (eg, confusion, agitation), no intervention needed

• Grade 2: Moderate symptoms, requires steroids or other interventions

• Grade 3: Severe symptoms (eg, encephalopathy, seizures), may require ICU and immunosuppressive therapy

• Grade 4: Life-threatening, requires intensive care and urgent interventions

Institutional Protocols:

• Prompt grading of symptoms is essential for early intervention.

Clear escalation protocols for managing CRS and ICANS, with specific guidance for steroid administration, monitoring, and ICU transfer if necessary.