Complex ES-SCLC Case: Tarlatamab Management Through Toxicity to Clinical Benefit
Panelists discuss how effective management of cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome in complex extensive-stage small cell lung cancer (ES-SCLC) cases treated with tarlatamab enables patients to continue therapy and achieve meaningful clinical benefit despite early toxicities.
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
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:
Complex Extensive-Stage Small Cell Lung Cancer Case: Tarlatamab Management Through Toxicity to Clinical Benefit
- Initial phase:
- Close inpatient monitoring during early cycles due to risk of cytokine release syndrome (CRS) and immune effector cell –associated neurotoxicity syndrome (ICANS).
- Gradual dose escalation may be used to improve tolerance.
- Toxicity management:
- Prompt recognition and management of grade 1 to 2 CRS with supportive care; grade 3 or greater may require tocilizumab and steroids.
- Neurotoxicity (ICANS) managed with neurology consults, steroids, and intensive care unit–level support if severe.
- Clinical benefit:
- Despite early toxicities, patients may achieve meaningful responses with tumor reduction and symptom improvement.
- Ongoing benefit often seen with continued outpatient infusions and proactive monitoring.
Key Takeaway:
- Effective toxicity management can allow patients to continue therapy and derive clinical benefit, even in high-risk or heavily pretreated cases.
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