Indirect Comparison of Tarlatamab vs. Chemotherapy (CTx) in Patients With Previously Treated, Platinum-Refractory, or Resistant Extensive-Stage Small Cell Lung Cancer (ES-SCLC)
Author(s)
Umit Tapan, MD1, Franziska Dirnberger, PhD2, Sachin Patel, MSc3, Devon Boyne, PhD4, Tommy Lan, MSc4, Jennifer Uyei, PhD5, Jessie Wang, PhD6, seoyoon Cho, PhD6, Lucy DeCosta, MSc3, Ian Bridges, MSc7.
1Hematology & Medical Oncology, Boston University Chobanian & Avedisian School of Medicine, and Boston Medical Center, Boston, MA, USA, 2Amgen GmbH, München, Germany, 3Amgen Ltd, Uxbridge, United Kingdom, 4IQVIA Inc, Kirkland, QC, Canada, 5IQVIA Inc, San Mateo, CA, USA, 6Amgen Inc, Thousand Oaks, CA, USA, 7Amgen Ltd, Cambridge, United Kingdom.
1Hematology & Medical Oncology, Boston University Chobanian & Avedisian School of Medicine, and Boston Medical Center, Boston, MA, USA, 2Amgen GmbH, München, Germany, 3Amgen Ltd, Uxbridge, United Kingdom, 4IQVIA Inc, Kirkland, QC, Canada, 5IQVIA Inc, San Mateo, CA, USA, 6Amgen Inc, Thousand Oaks, CA, USA, 7Amgen Ltd, Cambridge, United Kingdom.
Presentation Documents
OBJECTIVES: Tarlatamab showed considerable benefit in response, survival, and patient-reported outcomes compared to CTx (topotecan, lurbinectedin, or amrubicin) in ES-SCLC after first-line platinum-based therapy in the DeLLphi-304 trial (NCT05740566). While paclitaxel and cyclophosphamide/doxorubicin/vincristine (CAV) are treatment options for platinum-refractory or resistant ES-SCLC, there is a lack of head-to-head data comparing these treatments with tarlatamab. This study reports the relative efficacy of tarlatamab vs CAV and paclitaxel in the platinum-refractory or resistant subgroup assessed through indirect comparisons.
METHODS: Unanchored matching adjusted indirect comparisons (MAICs) were conducted using patient-level data for tarlatamab and published summary level data for paclitaxel (NCT02038647) in the chemotherapy-free interval [CFI] < 180 days subgroup and CAV (NCT00418743) in the CFI < 90 days subgroup. Hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS) were estimated after adjusting for differences in age, sex, smoking history, time since initial diagnosis, ECOG performance status, disease stage at initial diagnosis, and brain metastases. Sensitivity analyses were conducted restricting adjustment to imbalanced variables only.
RESULTS: A total of 188 patients receiving tarlatamab in the CFI < 180 days subgroup from the DeLLphi-304 trial were indirectly compared with 89 patients treated with paclitaxel. Similarly, 108 tarlatamab patients in the CFI < 90 days subgroup were compared with 66 patients receiving CAV. Tarlatamab was associated with significantly improved OS when compared to paclitaxel (HR [95%CI]: 0.35 [0.23, 0.52]) and CAV (0.48 [0.32, 0.70]). PFS was also significantly higher for tarlatamab compared to paclitaxel (HR [95%CI]: 0.59 [0.44, 0.78]) and showed a trend towards improvement compared to CAV (0.89 [0.63, 1.26]). Results from the sensitivity analyses were similar.
CONCLUSIONS: Tarlatamab offers significant efficacy benefit relative to paclitaxel and CAV in patients with platinum-refractory or resistant ES-SCLC in the second-line setting. These findings reinforce tarlatamab as an effective treatment option for this population.
METHODS: Unanchored matching adjusted indirect comparisons (MAICs) were conducted using patient-level data for tarlatamab and published summary level data for paclitaxel (NCT02038647) in the chemotherapy-free interval [CFI] < 180 days subgroup and CAV (NCT00418743) in the CFI < 90 days subgroup. Hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS) were estimated after adjusting for differences in age, sex, smoking history, time since initial diagnosis, ECOG performance status, disease stage at initial diagnosis, and brain metastases. Sensitivity analyses were conducted restricting adjustment to imbalanced variables only.
RESULTS: A total of 188 patients receiving tarlatamab in the CFI < 180 days subgroup from the DeLLphi-304 trial were indirectly compared with 89 patients treated with paclitaxel. Similarly, 108 tarlatamab patients in the CFI < 90 days subgroup were compared with 66 patients receiving CAV. Tarlatamab was associated with significantly improved OS when compared to paclitaxel (HR [95%CI]: 0.35 [0.23, 0.52]) and CAV (0.48 [0.32, 0.70]). PFS was also significantly higher for tarlatamab compared to paclitaxel (HR [95%CI]: 0.59 [0.44, 0.78]) and showed a trend towards improvement compared to CAV (0.89 [0.63, 1.26]). Results from the sensitivity analyses were similar.
CONCLUSIONS: Tarlatamab offers significant efficacy benefit relative to paclitaxel and CAV in patients with platinum-refractory or resistant ES-SCLC in the second-line setting. These findings reinforce tarlatamab as an effective treatment option for this population.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
SA54
Topic
Clinical Outcomes, Health Technology Assessment, Study Approaches
Topic Subcategory
Decision Modeling & Simulation, Meta-Analysis & Indirect Comparisons
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology