A multi-institutional perspective on tarlatamab administration and management of CRS/ICANS.

BACKGROUND: Tarlatamab, a bispecific T-cell engager, is the first treatment in many years to significantly improve overall survival in relapsed extensive stage small cell lung cancer (ES-SCLC). However, implementation of this therapy has been challenging due to unique toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) requiring prolonged observation following administration. METHODS: We conducted a U.S. based multi-institutional survey through the ONWARD-SCLC consortium, compromised of 15 academic and 1 community centers actively administrating tarlatamab. RESULTS: We received responses from 9 U.S. academic centers and 1 community-based practice, detailing their standard operating procedures and management of toxicities. While each had unique practices, common strategies included risk stratification, multidisciplinary coordination, communication and education, and well-defined workflows. We highlighted the similarities and differences in the approaches and proposed a list of best practice considerations for tarlatamab administration and toxicity management. CONCLUSIONS: This perspective highlights current best practices and suggests future directions to improve on our current approaches for tarlatamab administration and CRS/ICANS management.

Duke Scholars

Author Laura Ruth Alder Medicine, Medical Oncology