Introduction to Small Cell Lung Cancer (SCLC)
Small Cell Lung Cancer (SCLC) is a highly aggressive form of lung cancer characterized by small cells that grow and spread rapidly. It accounts for approximately 10-15% of all lung cancers. The diagnosis of SCLC often occurs at a later stage due to the rapid progression of the disease and the late onset of symptoms.
Diagnosis of SCLC
The diagnostic process for SCLC typically involves a combination of imaging studies and tissue sampling. Imaging studies such as chest X-rays, computed tomography (CT) scans, and positron emission tomography (PET) scans are used to identify the presence and extent of the tumor. A definitive diagnosis, however, relies on a histopathological examination, usually obtained through a biopsy. This can be done through various methods such as bronchoscopy, needle biopsy, or surgical biopsy.
Treatment of SCLC
The treatment of SCLC largely depends on the disease stage at diagnosis. In the limited stage, where cancer is confined to one side of the chest, a combination of chemotherapy and radiotherapy is the standard approach. The most common chemotherapy regimen includes a platinum drug (like cisplatin or carboplatin) combined with another chemotherapy drug (like etoposide or irinotecan).
In the extensive stage, where cancer has spread beyond one side of the chest or to other parts of the body, chemotherapy remains the mainstay of treatment, but the focus shifts to controlling the disease and alleviating symptoms. Recently, immunotherapy drugs such as atezolizumab and durvalumab have been approved for use in combination with chemotherapy in the first-line treatment of extensive-stage SCLC. These drugs work by helping the immune system recognize and attack cancer cells.
Unfortunately, no current treatments offer long-term disease control, leaving patients who progress on current treatments with few available options outside of clinical trials. However, the experimental drug tarlatamab has recently demonstrated promising results, and we will analyze these results below.
Tarlatamab in Recurrent SCLC
Tarlatamab, a DLL3/CD3 bispecific T-cell engager molecule by Amgen, was evaluated in the Phase 2 DeLLphi-301 study which enrolled 220 patients with relapsed/refractory SCLC. An objective response rate of 40% was observed, and patients experienced a median progression-free survival of 4.9 months. Despite a high incidence of low-grade side effects such as cytokine release syndrome, and decreased appetite, only 3% of patients discontinued the therapy due to side effects.
Ongoing Clinical Trials for Tarlatamab
- Recruiting - “First-Line Tarlatamab in Combination With Carboplatin, Etoposide, and PD-L1 Inhibitor in Subjects With Extensive Stage Small Cell Lung Cancer (ES-SCLC)“ Study Link
- To begin recruiting in January 2024 - Study Evaluating Tarlatamab After Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer (LS-SCLC) (DeLLphi-306) Study Link
- Recruiting - Study Comparing Tarlatamab With Standard of Care Chemotherapy in Relapsed Small Cell Lung Cancer (DeLLphi-304) - Study Link
To search for clinical trials in your city, and to register e-mail alerts for future trials, you can visit www.trialnotifier.com