What are the main practical factors to consider when using bispecific antibody therapy (Tarlatamab) for extensive-stage small cell lung cancer?

Tarlatamab is the newest FDA-approved therapy for relapsed SCLC. It received accelerated approval based on the DeLLphi-301 trial. Tarlatamab is a bispecific T-cell engager immunotherapy targeting delta-like ligand 3 and CD3. It has unique toxicities including CRS and ICANS and requires step-up dosin...

Patient fitness, comorbidities, and toxicities to prior therapy. This is especially relevant as most patients will have received front line immunotherapy - however, the DeLLphi-301 protocol excluded patients who have a diagnosis of immunodeficiency and or are receiving systemic steroid therapy or im...

The main issue from my perspective is having the staff on knowing how to observe and treat potential side effects with the first 2 administrations. Knowledge of CRS symptoms, and not overreacting or underreacting are key issues. Other practical issues are bed and staff availability which can be a ma...