What is Tarlatamab: Uses, Dosage, Side Effects and More

Tarlatamab is a targeted cancer treatment specifically designed to fight small cell lung cancer. This medication works by helping your immune system recognize and attack cancer cells more effectively, offering hope for patients whose cancer has spread or returned after other treatments.

This relatively new treatment represents an important advancement in cancer care. It belongs to a class of medications called bispecific T-cell engagers, which essentially act as a bridge between your immune system and cancer cells.

What is Tarlatamab?

Tarlatamab is a prescription medication that treats adults with extensive-stage small cell lung cancer. It's given through an IV infusion directly into your bloodstream, allowing the medicine to reach cancer cells throughout your body.

The drug targets a specific protein called DLL3 that's found on small cell lung cancer cells. By binding to both the cancer cells and your immune system's T-cells, it helps coordinate a more effective attack against the tumor.

Your doctor will typically consider this treatment when your cancer has progressed despite receiving at least two other types of cancer therapy. It's not a first-line treatment but rather a specialized option for more advanced cases.

What is Tarlatamab Used For?

Tarlatamab treats extensive-stage small cell lung cancer in adults whose disease has progressed after receiving platinum-based chemotherapy and at least one other prior therapy. This specific type of lung cancer tends to grow and spread quickly, making targeted treatments like this particularly valuable.

The medication is designed for patients whose cancer has either spread to other parts of the body or returned after previous treatments. Your oncologist will determine if you're a good candidate based on your specific cancer characteristics and treatment history.

It's important to understand that this isn't a cure, but rather a treatment that can help slow cancer growth and potentially extend life. Many patients experience meaningful improvements in their quality of life while receiving this therapy.

How Does Tarlatamab Work?

Tarlatamab works by creating a direct connection between your immune system's T-cells and the cancer cells. Think of it as introducing two cells that need to work together but haven't been communicating effectively.

The medication binds to a protein called DLL3 on the surface of cancer cells and simultaneously attaches to CD3 receptors on your T-cells. This creates a bridge that brings these cells close together, allowing your immune system to recognize and destroy the cancer more efficiently.

This is considered a moderately strong cancer treatment that can produce significant responses in many patients. However, because it activates your immune system so directly, it requires careful monitoring and management of potential side effects.

How Should I Take Tarlatamab?

Tarlatamab is given as an intravenous infusion in a healthcare setting, typically a cancer treatment center or hospital. You cannot take this medication at home, as it requires professional medical supervision during administration.

Before each infusion, your healthcare team will likely give you medications to help prevent infusion reactions. These might include antihistamines, steroids, or fever reducers to help your body tolerate the treatment better.

The infusion itself usually takes about 4 hours for the first dose, with subsequent doses potentially taking less time. You'll need to stay for observation after each treatment to monitor for any immediate reactions.

There are no specific food restrictions with tarlatamab, but it's generally recommended to eat a light meal before treatment. Staying well-hydrated before and after your infusion can help minimize some side effects.

How Long Should I Take Tarlatamab For?

The duration of tarlatamab treatment varies significantly from person to person and depends on how your cancer responds and how well you tolerate the medication. Some patients may receive treatment for several months, while others may continue for a year or longer.

Your oncologist will regularly monitor your cancer through scans and blood tests to assess whether the treatment is working. These evaluations typically happen every 6-8 weeks initially, then may be spaced further apart if your cancer remains stable.

Treatment usually continues as long as your cancer isn't progressing and you're not experiencing unacceptable side effects. If serious side effects develop, your doctor might temporarily pause treatment or adjust the dosing schedule.

The decision to stop treatment will always be made collaboratively between you and your healthcare team, taking into account your overall health, quality of life, and treatment goals.

What Are the Side Effects of Tarlatamab?

Like all cancer treatments, tarlatamab can cause side effects, though not everyone experiences them. The most common side effects are related to the medication's effect on your immune system and typically occur within the first few days after treatment.

Here are the most frequently reported side effects that you should be aware of:

• Cytokine release syndrome (fever, chills, difficulty breathing, low blood pressure)
• Skin rash or itching
• Fatigue and weakness
• Nausea and decreased appetite
• Fever and flu-like symptoms
• Changes in blood cell counts
• Elevated liver enzymes

Most of these side effects are manageable with proper medical care and tend to improve as your body adjusts to the treatment. Your healthcare team will provide you with detailed instructions on what to watch for and when to seek immediate medical attention.

Some patients may experience more serious but less common side effects, including severe immune system reactions or neurological symptoms. These require immediate medical attention and might necessitate stopping treatment temporarily or permanently.

Who Should Not Take Tarlatamab?

Tarlatamab isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. People with certain health conditions or circumstances may not be good candidates for this treatment.

Your doctor will likely advise against tarlatamab if you have any of these conditions:

• Severe heart disease or recent heart attack
• Active, uncontrolled infections
• Severe liver or kidney disease
• Autoimmune disorders that are poorly controlled
• Pregnancy or breastfeeding
• Severe lung disease unrelated to cancer

Additionally, if you've had severe allergic reactions to similar medications in the past, your doctor will weigh the risks and benefits very carefully. Age alone isn't necessarily a barrier, but your overall health status and ability to tolerate treatment will be important factors.

Your oncologist will review your complete medical history and current health status to determine if tarlatamab is the best treatment option for your specific situation.

Tarlatamab Brand Name

Tarlatamab is sold under the brand name Imdelltra by Amgen Inc. This is currently the only available brand formulation of this medication, as it's a relatively new treatment that received FDA approval in 2024.

When you receive your treatment, you'll see Imdelltra on the medication labels and in your medical records. There are no generic versions available at this time, as the medication is still under patent protection.

Your insurance coverage and treatment center will work with Amgen's patient support programs if you need assistance with costs or access to the medication.

Tarlatamab Alternatives

If tarlatamab isn't suitable for you or stops working, several other treatment options exist for small cell lung cancer. Your oncologist will consider your specific situation, previous treatments, and overall health when discussing alternatives.

Other targeted therapies and immunotherapy options include lurbinectedin, topotecan, and various clinical trial medications. Some patients might benefit from combination chemotherapy regimens or participate in research studies testing newer treatments.

The choice of alternative treatment depends heavily on what treatments you've already received, your current health status, and your personal preferences. Your healthcare team will work with you to explore all appropriate options if tarlatamab isn't the right fit.

Is Tarlatamab Better Than Other Small Cell Lung Cancer Treatments?

Tarlatamab offers a unique mechanism of action compared to traditional chemotherapy, but whether it's "better" depends on your individual circumstances. Clinical trials have shown promising results, with some patients experiencing significant tumor shrinkage and improved quality of life.

Compared to standard chemotherapy options like topotecan, tarlatamab may offer longer-lasting responses in some patients. However, it also comes with different side effects and requires more intensive monitoring, especially during the initial treatment period.

The "best" treatment varies from person to person based on factors like your overall health, previous treatments, cancer characteristics, and personal preferences. Your oncologist will help you understand how tarlatamab compares to other options in your specific situation.

Many patients find that having access to this newer treatment option provides hope and potentially better outcomes than previously available therapies, but individual results can vary significantly.