UVA Health is the first Virginia healthcare provider to offer tarlatamab for small cell lung cancer patients. The FDA recently approved this new treatment in the second line setting for patients with stage 4 disease.
Tarlatamab is a specific type of immunotherapy called a bispecific T-cell engager (BiTE). It binds both DLL3 and CD3, leading to T-cell–mediated tumor destruction. In clinical trials, median survival for patients who received this treatment was 14 months, which is longer than other currently available treatments.
When to Consider BiTE Therapy for Your Patients
UVA Health thoracic oncologist and researcher Richard Hall Jr., MD, encourages providers to refer patients for BiTE therapy when imaging shows tumor growth after first line therapy.
Most stage 4 small cell patients progress after first line treatment with chemo and immunotherapy in less than 6 months. Before tarlatamab, few options existed for these patients.
“If you have a patient with stage 4 SCLC, it’s important to recognize this as an option for the next line of therapy,” says Hall. “There’s a high probability the patient’s disease will progress after initial treatment.”
UVA Health’s Early Experience With BiTE & Managing Side Effects
Patients who receive BiTE therapy require close monitoring for cytokine release syndrome (CRS). This syndrome can cause fever, low blood pressure, high heart rate, and difficulty breathing.
The team is experienced in monitoring for and treating these side effects. The UVA Health team participated in an expanded access protocol of the phase 3 clinical trial for tarlatamab, allowing us to gain experience early on with the treatment. We’ve administered tarlatamab to more than 20 patients since April, including those treated prior to FDA approval.
UVA Health clinicians and researchers were among the first to recognize and develop treatment protocols for CRS during the development of CAR T-cell therapy for blood cancers.
“We created a full, multidisciplinary BiTE standard operating procedure,” Hall explains. Patients referred to UVA Health for this treatment will be treated and cared for by deeply informed, highly knowledgeable experts in all aspects of the therapy.
Expanding Access: BiTE Therapy in the Outpatient Setting
To ease the treatment experience for patients, we now offer BiTE therapy on an outpatient basis. This includes extended hours at our infusion center for monitoring during the day. Patients then receive a special monitoring kit to use at home overnight.
Patients need a caregiver with them to measure vitals frequently. They also must stay within 1 hour’s drive of UVA Health Medical Center in Charlottesville. For patients who live further away, we offer help finding lodging.
Logistical Support for Every Patient
Upon referral, we connect patients with our nurse navigator, who helps the patient:
- Coordinate treatments and clinic visits
- Complete a needs assessment
- Find financial assistance, lodging, and other resources
Our nurse navigator can also assist you with the referral process, communication with our clinical team during treatment, and transitioning care back to you after treatment.
Refer Your Patient for BiTE Therapy
To refer a patient, call the UVA Cancer Center at 434.924.9333 and ask for the thoracic cancer nurse navigator.
