ESMO 2026 | Real-world cytokine release syndrome with tarlatamab in SCLC

So, you know, tarlatamab is a DLL3 T-cell engager, and it’s certainly provided robust and exciting data in the second-line extensive-stage small cell lung cancer space. And with that, we’re continuing to use it more and more in the second-line space, but also in the first-line setting now, with promising data coming up in the first-line maintenance phase with immunotherapy and perhaps moving up into the frontline chemoimmunotherapy combination. We anticipate using a lot of tarlatamab in the small cell population. But CRS remains the most common toxicity with this population, and the operational barriers of CRS monitoring and toxicity management have created perhaps access barriers for patients. So, you know, we certainly feel there’s a need to better understand the real-world experience with CRS in this population. So when you look at the DeLLphi-301 study, more than 53% of the patients actually had CRS. If you go deeper into the study, the DeLLphi-301 study led to the U.S. label recommendations of 24 hours of monitoring after the first and second doses. And that’s sort of what the practice has been until now. But when you delve deeper into the pooled safety analysis from the DeLLphi studies, which looks at a significantly larger number of patients from DeLLphi-301, DeLLphi-300, and DeLLphi-304, they actually show that 57% of the patients did have CRS. However, the majority of those CRS events were grade 1 and 2, and a significant number of those CRS events happened after the first and second doses. So we really saw grade 2 or higher CRS after cycle 2 in only about 1.5% of patients. So we did know from this data that a lot of these CRS events were happening early, and a lot of these were grade 1 and 2. So I think we wanted a more real-world experience in seeing, in our actual population, what the experience has been. So we utilized the TriNetX database, which is a global health research network that pulls electronic health records from participating organizations. It’s de-identified medical information. And so we queried the data on May 12, 2026, and data from about 173 healthcare organizations was collected. We had over 700 patients identified as receiving tarlatamab with extensive-stage small cell lung cancer. And so we recorded outcomes such as CRS diagnosis and management outcomes, such as ICU and hospital admissions. And very interestingly, contrary to what we’ve seen in the DeLLphi studies, we saw only about 19% of these patients actually were recognized or recorded as having CRS. So less than 50% of the patients… So over 700 patients received tarlatamab as part of this database. Less than 50% were hospitalized, and CRS was seen in about 19% of patients. 

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