The Food and Drug Administration (FDA) approved Imdelltra (tarlatamab) for the treatment of patients with advanced small cell lung cancer (SCLC) that progressed on or after a platinum-based chemotherapy, according to the agency.
“The FDA’s approval of Imdelltra marks a pivotal moment for patients battling ES-SCLC. This DLL3-targeting therapy in ES-SCLC comprises a transformative option demonstrating long-lasting responses in pretreated patients,” said Dr. Jay Bradner, executive vice president, research and development and chief scientific officer at Amgen. “Imdelltra offers [hope to] these patients who are in urgent need of new innovative therapies.”
The approval is based off findings from the phase 2 results from the DeLLphi-301 clinical trial that were presented at the 2023 European Society for Medical Oncology Congress and published in the New England Journal of Medicine in October 2023. The trial investigated two separate doses of Imdelltra 10 mg and 100 mg.
The objective response rate (ORR; patients whose disease responded partially or completely to treatment) was 40%, with a median duration of response of 9.7 months, the agency reported. Among 69 patients with available data regarding platinum sensitivity, the ORR was 52% for 27 patients with platinum-resistant SCLC and 31% for 42 patients with platinum-sensitive SCLC.
Imdelltra is a type of drug called a bispecific T-cell engager, also known as BiTE therapy. According to data published by the National Institutes of Health, the drug works by binding to the Delta-like 3 (DLL3) protein on cancer cells and the CD3 protein on immune T cells. In doing so, it recruits and activates the T cells to destroy tumor cells.
The prescribing information of Imdelltra includes a Boxed Warning for serious or life-threatening cytokine release syndrome (CRS; a potentially serious condition that includes a increase in inflammatory markers, called cytokines, in the blood) and neurologic toxicity, including immune effector cell-associated neurotoxicity syndrome (ICANS), according to the FDA, which reported that the most common side effects were CRS, fatigue, fever, taste changes, decreased appetite, musculoskeletal pain, constipation, anemia and nausea.
The most common severe or life-threatening laboratory abnormalities were decreased lymphocytes, decreased sodium, increased uric acid, decreased total neutrophils, decreased hemoglobin, increased activated partial thromboplastin time and decreased potassium.
Imdelltra’s recommended dose is an initial dose of 1 milligram as an intravenous infusion over one hour on cycle one Day one, followed by 10 mg on cycle one day eight and day 15, then every two weeks until disease progression or unacceptable toxicity.
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