Aman Chauhan, Associate Professor at the University of California, San Francisco, shared on X:
“Excited to share our latest publication in the Journal of Thoracic Oncology!
The ONWARD-SCLC consortium study brings together 265 patients from 11 U.S. academic centers to examine tarlatamab outcomes and safety in everyday clinical practice.
Key insights
- Real-world patients are sicker than trial patients. 44.5% had new or progressive brain metastases, 39.2% had liver metastases, and 12.5% had ECOG PS ≥2.
- The benefit holds up but is more modest. Disease control was 52.6% among evaluable patients, with median real-world PFS of 2.3 months and OS of 8.0 months, versus 4.2 and 13.6 months in the trial.
- Brain metastases did not blunt activity. CNS disease control was 68%, and systemic PFS was similar with or without brain metastases.
- Toxicity is front-loaded. CRS (40.8%) and ICANS (21.5%) peaked with the first step-up dose and fell sharply by C1D15. Grade 3–4 CRS and ICANS were more frequent than in trials, and only 10.6% received prophylaxis, so the role of prophylaxis deserves prospective study.
- Patient selection matters. Insulin-dependent diabetes, an urgent care visit within 30 days, more prior lines, liver metastases, and higher ALT predicted worse survival, while higher albumin was protective.
A special shout-out to Dr. Sonam Puri for envisioning this collaboration and leading the Herculean effort of bringing so many academic centers together. Turning a shared vision into a dataset this rich takes extraordinary leadership, persistence, and teamwork!
Proud to be part of this effort and grateful to all the investigators, research teams, and, most of all, the patients who made it possible. More insights are coming from this dataset. Looking at you, Rafey Naqash et al.!”
Title: Tarlatamab for Treatment of Small Cell Lung Cancer in Clinical Practice: A Multicenter U.S. Retrospective Cohort Study from the ONWARD consortium
Authors: Utsav Joshi, Bingnan Zhang, Zachary J. Thompson, Aakash Desai, Abdul R. Naqash, Alexis L. Green, Alissa J. Cooper, Aman Chauhan, Yunan Nie, Ayesha Aijaz, Chinmay T. Jani, Daniel L. Hess, Daniela C. Bravo Solarte, Falah Fayaz, Frank Weinberg, Graeme Fenton, Jacob M. Sands, Jessica Ross, Juhi Gor, Kaiwen Wang, Laura Alder, Mark B. Botros, Misty D. Shields, Mitchell Parma, Pravash Budhathoki, Sameer Deshmukh, Samuel Rosner, Anne C. Chiang, Jhanelle E. Gray, Sonam Puri.
Continue exploring:
Tarlatamab: Mechanism, Neurotoxicity, and the Next Chapter in SCLC Treatment
