A clinical study to investigate the efficacy of Tarlatamab in individuals with advanced stage small cell lung cancer (ES-SCLC) whose disease has progressed during or after prior treatment and whose general condition is compromised.

France, Greece, Italy, Spain, Switzerland (ICTRP)

ICTRP Trial ID
NCT07203053 (ICTRP)

Official title (approved by ethics committee)
A multicentre phase II trial of tarlatamab in patients with pretreated extensive-stage small cell lung cancer (ES-SCLC) and ECOG PS 2 (BASEC)

Academic title
A Multicentre Phase II Trial of Tarlatamab in Patients With Pretreated Extensive-stage Small Cell Lung Cancer (ES-SCLC) and ECOG PS 2 (ICTRP)

Public title
A Trial of Tarlatamab in Patients With Pretreated Extensive-stage Small Cell Lung Cancer (ES-SCLC) and ECOG PS 2 (ICTRP)

Disease under investigation
Extensive Stage Lung Small Cell Cancer (ICTRP)

Intervention under investigation
Drug: Tarlatamab (ICTRP)

Type of trial
Interventional (ICTRP)

Trial design
Allocation: N/A. Intervention model: Single Group Assignment. Primary purpose: Treatment. Masking: None (Open Label). (ICTRP)

Inclusion/Exclusion criteria
Inclusion Criteria:

- Histologically or cytologically confirmed ES-SCLC.

- Previous treatment with only one line of platinum-etoposide doublet chemotherapy
with immune-checkpoint inhibition for SCLC.

Patients treated with a platinum-etoposide doublet chemotherapy for prior limited stage
(LS)-SCLC may be eligible for the study if the disease has progressed on treatment or
within 6 months from chemotherapy completion (i.e. during durvalumab consolidation): the
platinum-etoposide line of therapy will count as one prior line of therapy.

- Progressive disease on or after the first-line treatment for SCLC.

- ECOG Performance Status 2.

- Age =18 years.

- Adequate haematological, renal and liver function.

- Coagulation function: Prothrombin time (PT)/international normalised ratio (INR) and
partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT)
=1.5x ULN, except for patients receiving anticoagulation, who must be on a stable
dose of anticoagulation therapy for 6 weeks prior to enrolment.

- Pulmonary function:

- No clinically significant pleural effusion. Pleural effusion managed with
indwelling pleural catheter (e.g., PleurX) are allowed.

- Baseline oxygen saturation >90% on room air.

- Cardiac function: Left ventricular ejection fraction (LVEF) =50%, no clinically
significant pericardial effusion as determined by an echocardiogram (ECHO) or
multigated acquisition (MUGA) scan (preferred), and no clinically significant
electrocardiogram (ECG) findings.

- Women of childbearing potential, must have a negative urinary or serum pregnancy
test within 5 weeks before enrolment. Pregnancy test must be repeated within 3 days
before the first dose of tarlatamab treatment.

- Written Informed Consent must be signed and dated by the patient and the
investigator prior to any trial-related intervention.

Exclusion Criteria:

- Symptomatic CNS metastases Patients with untreated asymptomatic brain metastases and
patients with treated and stable brain metastases are eligible.

- Diagnosis or evidence of leptomeningeal disease or spinal cord compression

- Prior history of immune-checkpoint inhibitor treatment resulting in:

- any severe or life-threatening immune-mediated adverse event,

- history of immune-mediated encephalitis or another immune-mediated CNS event
(any grade),

- grade =2 immune-mediated recurrent pneumonitis,

- infusion-related reactions leading to permanent discontinuation of the
immunotherapy agent.

Exception: patients with a history of immune-checkpoint inhibitor-induced endocrinopathy
which is clinically stable on replacement therapy.

- Active autoimmune disease that has required systemic treatment (except replacement
therapy) within the past 2 years or any other diseases requiring immunosuppressive
therapy while on study.

- History of solid organ transplantation.

- Treatment with live virus, including live-attenuated vaccination within 14 days
prior to enrolment and inactive vaccines (e.g., non-live or non-replicating agent)
and live viral non-replicating vaccines (e.g., Jynneos for Monkeypox infection)
within 3 days prior to enrolment.

- History of other malignancy within the past 2 years, with the following exceptions:

- Low-risk malignancy treated with curative intent and with no known active
disease present for =1 year before enrolment and believed to be at low risk for
recurrence per investigator discretion.

- Adequately treated non-melanoma skin cancer or lentigo maligna without evidence
of disease.

- Adequately treated cervical carcinoma in situ without evidence of disease.

- Adequately treated breast ductal carcinoma in situ without evidence of disease.

- Prostatic intraepithelial neoplasia without evidence of prostate cancer.

- Adequately treated urothelial papillary non-invasive carcinoma or carcinoma in
situ.

- Myocardial infarction and/or symptomatic congestive heart failure (New York Heart
Association >class II) within 12 months prior to enrolment.

- History of arterial thrombosis (e.g., stroke or transient ischemic attack) within 12
months prior to enrolment.

- Presence/history of an uncontrolled viral infection:

- Known uncontrolled human immunodeficiency virus (HIV) infection.

- Active hepatitis C infection (patients with detectable hepatitis C antibody
[HCV Ab] and HCV RNA viral load above the limit of quantification).

- Patients with presence of HCV Antibodies and HCV RNA viral load below the limit
of quantification (HCV RNA negative) with or without prior treatment are
allowed.

- Active hepatitis B infection (presence of hepatitis B surface antigen [HBsAg]
and hepatitis B virus [HBV] DNA viral load above the limit of quantification
[HBV DNA positive]).

- Patients with resolved HBV infection defined as absence of HBsAg and presence
of HBV core antibody (anti-HBc) followed by an HBV DNA viral load below the
limit of quantification (HBV DNA negative) are allowed, with a requirement for
regular monitoring for reactivation for the duration of treatment on the study
and assessing the need for HBV prophylaxis therapy per local or institutional
guidelines.

- Patients with chronic HBV infection inactive carrier state defined as presence
of HBsAg and HBV DNA viral load below the limit of quantification [HBV DNA
negative] are allowed, with a requirement for regular monitoring for
reactivation for the duration of treatment on the study and assessing the need
for HBV prophylaxis therapy per local or institutional guidelines.

- Receiving systemic corticosteroid therapy or any other form of immunosuppressive
therapy within 7 days prior to first dose of study treatment.

- Prophylactic dexamethasone for the management of tarlatamab-related adverse
events and any anti-emetic therapies are allowed.

- Low-dose corticosteroids (prednisone =10 mg per day or equivalent) is permitted
during the trial.

- Patients with symptoms and/or clinical signs and/or radiographic signs that indicate
an acute and/or uncontrolled active systemic infection within 7 days prior to the
first dose of study treatment.

- Patient has known active infection requiring parenteral antibiotic treatment.
Upon completion of parenteral antibiotics and resolution of symptoms, the
patient may be considered eligible for the study from an infection standpoint.

- Note: Simple urinary tract infection (UTI) and uncomplicated bacterial
pharyngitis are permitted if responding to active treatment. Subjects requiring
oral antibiotics who have been afebrile for >24 hours, have no leucocytosis,
nor clinical signs of infection are eligible. Screening for chronic infectious
conditions is not required unless otherwise noted as exclusion criteria.

- Evidence of interstitial lung disease or active, non-infecti (ICTRP)

not available

Primary and secondary end points
Overall survival rate at 12 months (12-month OS) (ICTRP)

Objective response rate (ORR);Duration of response (DoR);Disease control rate (DCR);Progression-free survival (PFS);Incidence, nature, and severity of adverse events (ICTRP)

Registration date
not available

Incorporation of the first participant
not available

Secondary sponsors
Amgen (ICTRP)

Additional contacts
Maurice Prol, MDFederico Capuzzo, MDHeidi Roschitzki, PhD, heidi.roschitzki@etop.ibcsg.org, +41 31 511 94 00, Centre Lon Brard, Lyon, FranceIRCCS Regina Elena, Rome, Italy (ICTRP)

Secondary trial IDs
ETOP 29-25 (ICTRP)

Results-Individual Participant Data (IPD)
not available

Further information on the trial
https://clinicaltrials.gov/study/NCT07203053 (ICTRP)