Prof Martin Schuler talks to ecancer at ESMO 2025 about safety analysis data he presented from The DeLLphi-304 phase III study evaluating tarlatamab, a DLL3-targeting bispecific T-cell engager, versus standard chemotherapy in patients with previously treated small cell lung cancer (SCLC).

The study found that fewer haematologic toxicities and infections occurred with tarlatamab compared to chemotherapy.

Grade ≥3 treatment-related adverse events (TRAEs) declined over time on tarlatamab (17% in month 1 to 12% beyond month 3), whereas chemotherapy TRAE rates remained over 38%.

Cytokine release syndrome (CRS) was the most common tarlatamab-related AE (56%), generally manageable, and hospitalization rates were low.

Neurologic events occurred in 45% of patients, with ICANS being rare (6%) and mostly mild, while dysgeusia was common (23%) but did not lead to treatment discontinuation.

Prof Schuler notes that tarlatamab showed a predictable and manageable safety profile in second-line SCLC, with no new safety signals, supporting its tolerability alongside previously observed efficacy benefits.