Differential Toxicity Profile: Tarlatamab vs Traditional Cytotoxic Therapies

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Panelists discuss how tarlatamab’s toxicity profile differs from traditional cytotoxic therapies, highlighting its immune-related adverse effects such as cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome, while noting its lower risk of myelosuppression and long-term organ damage compared with chemotherapy, which tends to cause cumulative toxicities such as bone marrow suppression.

Summary for Physicians:

Differential Toxicity Profile: Tarlatamab vs Traditional Cytotoxic Therapies

  • Tarlatamab (immunotherapy):
  • Immune-related toxicities: Includes cytokine release syndrome, immune effector cell–associated neurotoxicity syndrome, and immune-related adverse events (eg, rash, colitis)

  • Less myelosuppression compared with traditional chemotherapy

  • Onset of adverse effects is typically within 24 to 48 hours post infusion
  • Traditional cytotoxic therapies:
  • Common toxicities: Myelosuppression, nausea/vomiting, alopecia, fatigue, and mucositis

  • Delayed onset of adverse effects (often seen after several cycles)

  • Dose-limiting toxicities often related to bone marrow suppression

Key Differences:

  • Tarlatamab may cause acute immune reactions but spares long-term organ damage compared with cytotoxic therapies.

Traditional chemotherapies are associated with cumulative toxicities over time, particularly myelosuppression, which is less of a concern with tarlatamab.

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