DeLLphi-304 was a randomised phase III trial evaluating the efficacy and safety of tarlatamab, which is a T-cell engager, as a second-line treatment for patients with extensive stage small cell lung cancer whose disease had progressed after first-line chemotherapy plus/minus an immune checkpoint inhibitor. One of the secondary endpoints of this trial was the evaluation of patient-reported outcomes.

What was the design of the study?

In this study we looked at patient-reported outcomes as a key secondary endpoint of the study. What we found was that for the subgroup of patients that was allocated to tarlatamab therapy, patients had an overall better preserved quality of life, especially in terms of symptoms that can be really bothersome for patients with small cell lung cancer. So we had statistically significant improvement in patient-reported evaluation at week 16 as compared to baseline in symptoms like dyspnea and like cough, whereas for the symptom of chest pain there was a numerical, albeit non statistically significant, improvement in patient-reported outcomes.

Overall, this poster that was presented in ESMO 2025 showed that in key patient-reported symptoms tarlatamab was better tolerated as compared to standard second-line chemotherapy. Importantly, tarlatamab delayed the occurrence or the severity of symptoms like cough, chest pain and dyspnea which are very relevant for the quality of life of our patients with small cell lung cancer.

What is the potential impact of these findings?

In my opinion, those findings reinforce the value of tarlatamab in particular as the standard of care second-line treatment in extensive stage small cell lung cancer compared to standard second-line chemotherapy because it significantly improved overall survival and other efficacy endpoints compared to chemotherapy. At the same time it improved patient-reported outcomes or delayed the progression of bothersome symptoms for patients in the experimental arm.