Tarlatamab: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
Tarlatamab: clinical details
Prescribing considerations
- Initiate and supervise treatment through clinicians experienced in managing small cell lung cancer.
- Administer only where CRS, ICANS, hypersensitivity and other severe reactions can be recognised and treated promptly.
- Assess hydration and arrange required preventive treatment and post-infusion observation.
- Record the product name and batch number for biological-medicine traceability.
- Safety and efficacy have not been established in children.
- Experience is limited in active brain metastases, and the benefit–risk balance is not established.
- Severe renal impairment and more advanced hepatic impairment have not been adequately studied.
Contraindications and cautions
- Hypersensitivity to tarlatamab or any formulation excipient.
Monitoring
- Monitor for CRS during and after administration, including temperature, blood pressure, oxygenation and cardiorespiratory status as clinically indicated.
- Monitor neurological status for ICANS, which can be delayed.
- Check full blood count, liver enzymes and bilirubin before treatment and subsequently as clinically indicated.
- Monitor for hypersensitivity and adverse effects from narrow-therapeutic-index CYP450 substrates.
Clinical pharmacology
Tarlatamab is a bispecific antibody construct that binds DLL3 on tumour cells and CD3 on T cells, redirecting T-cell activation and cytotoxicity towards DLL3-positive cells. It is expected to undergo catabolic breakdown into peptides and amino acids.
Formulation and product differences
- Supplied as a single-use powder vial with separate intravenous solution stabiliser.
- Vial strengths have different concentrations after reconstitution and are not interchangeable during preparation.
- Sterile water reconstitutes the powder; the stabiliser is added to the infusion bag to reduce adsorption and must not be used for reconstitution.
- The preparation contains no antimicrobial preservative and requires strict aseptic technique.
Tarlatamab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 1 mg, 10 mg
Tarlatamab interactions
Formal interaction studies have not been performed. Cytokine release after starting tarlatamab may temporarily suppress CYP450 enzymes and increase exposure to some medicines.
Sirolimus, tacrolimus and other narrow-therapeutic-index CYP450 substrates
Blood concentrations and adverse effects may increase. Clinical assessment, concentration monitoring and adjustment of the interacting medicine may be required.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.