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ESMO 2023 – Amgen keeps tarlatamab filing plans under wraps

Present wrapped up with pink ribbon around it

Amgen impressed at ESMO today with full data on tarlatamab in third-line or later small-cell lung cancer – but it's still unclear whether the DLL3-targeting project can get approved on the available evidence. The data, also published in NEJM, come from the phase 2 Dellphi-301 study, which Amgen has described as “potentially registrational”. But the trial is uncontrolled, and the company already has a phase 3 study under way comparing tarlatamab against standard of care. All Amgen would tell ApexOnco is that it is “actively discussing” the latest results with the FDA and other regulators. A strange feature of the data was that the 10mg dose outperformed 100mg, something that Evercore ISI's Jon Miller suggested could be down to losing the ability to form a ternary complex at high doses. In any case Amgen is now focused on 10mg. Today’s presentation also shed more light on adverse events, including one treatment-related death from respiratory failure in the 10mg group. Presenting the results, Dr Luis Paz-Ares of Hospital Doce de Octubre said toxicity was “manageable”, but the discussant, Dr Pilar Garrido of Hospital Universitario Ramón y Cajal, highlighted the need for in-patient monitoring. 

 

Notable trials of tarlatamab

TrialStage & detailsData
Dellphi-301220-pt ph2 uncontrolled in ≥3L SCLC (10mg & 100mg), not preselected for DLL3 positivity40% ORR with 10mg dose (40/100 pts) at ESMO 2023, responses seen regardless of DLL3 expression; ≥gr3 AEs 26% & 33% with 10mg & 100mg respectively
Dellphi-302Ph1b + AMG 404 (PD-1 inhibitor) in ≥2L SCLCCompleted Jul 2023
Dellphi-303Ph1b + SOC in 1L SCLCEnds Nov 2024
Dellphi-304Ph3, tarlatamab 10mg vs SOC in 2L SCLCEnds Nov 2024

Source: Amgen, OncologyPipeline.

This story has been updated with comments from Evercore ISI.

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