Imdelltra (tarlatamab) is a medication used to treat advanced lung cancer that has spread, called extensive-stage small cell lung cancer (ES-SCLC). It’s approved for adults who have already been treated with platinum-based chemotherapy. This medication is a bispecific antibody, which helps your immune system find and attack cancer cells. It’s given by a healthcare professional as an intravenous (IV) infusion in a clinic or hospital. Common side effects include tiredness, fever, changes in taste, and a serious reaction called cytokine release syndrome (CRS).
Extensive-stage small cell lung cancer (ES-SCLC) in adults whose cancer has worsened after platinum-based chemotherapy
Imdelltra (tarlatamab) is a bispecific T-cell engager (BiTE), which is a type of monoclonal antibody that’s designed to bind to two different targets. One side of the antibody attaches to DLL3, a protein on cancer cells, while the other side binds to CD3, a protein on T-cells in your immune system. By connecting these two cells, Imdelltra (tarlatamab) brings T-cells close to the cancer cells, helping the immune system attack and destroy the cancer cells.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Works in a more specific, targeted way than traditional chemotherapy
Recommended therapy for advanced small cell lung cancer
Given every 2 weeks after initial doses
Requires long observations times with the first few doses
Commonly causes tiredness, fever, and changes in taste
Raises your risk of infection
Imdelltra (tarlatamab) can cause a serious immune reaction called cytokine release syndrome (CRS). Call your oncologist right away if you have fever, chills, fast or irregular heartbeat, trouble breathing, or dizziness.
To help prevent CRS, your oncology care team will give you premedications like dexamethasone 1 hour before your first few doses of Imdelltra (tarlatamab). You’ll also get fluids right after each infusion.
If you stop taking Imdelltra (tarlatamab) for a while, you might need to restart the step-up dosing schedule. This depends on how long the break was and when it happened.
Each Imdelltra (tarlatamab) infusion takes about 1 hour. You'll also need to stay afterward for monitoring, so plan for a full day and bring something to help pass the time.
You will be watched for several hours after your Imdelltra (tarlatamab) infusion, especially during the first few treatment cycles. If you don’t have serious side effects like CRS, this time can get shorter with later doses.
For the first two doses of Imdelltra (tarlatamab), you must stay within 1 hour of a healthcare center for 48 hours. Make sure a caregiver is with you during this time in case you need help.
A fever of 100.4°F or higher during Imdelltra (tarlatamab) treatment could mean you have CRS or an infection. Call your oncologist or get help right away if this happens.
Always carry your Patient Wallet Card while taking Imdelltra (tarlatamab). This lets other healthcare professionals know about your medication in case of an emergency.
Imdelltra (tarlatamab) can affect your brain and nerves. Tell your care team if you have a headache, feel dizzy or confused, or notice shaking. Don’t drive or use heavy machines until your symptoms are gone.
Imdelltra (tarlatamab) commonly lowers your blood cell counts. This can make it harder for your body to fight off infections. Let your oncologist know right away if you have fever, chills, cough, or trouble breathing.
It’s important to stay hydrated while taking Imdelltra (tarlatamab). You’ll get fluids through an IV on treatment days, but be sure to drink plenty of water between doses too.
Imdelltra (tarlatamab) can harm an unborn baby. If you can become pregnant, use birth control during treatment and for 2 months after your last dose. Let your oncologist know right away if you become pregnant.
Don’t breastfeed while taking Imdelltra (tarlatamab) and for 2 months after the last dose. It’s not known if this medication passes into breast milk, but it could be harmful to a nursing baby.
Imdelltra (tarlatamab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Imdelltra (tarlatamab) can cause a reaction called cytokine release syndrome (CRS). CRS happens when your immune system reacts too strongly to the medication. Symptoms can include headache, chills, fever, low blood pressure, trouble breathing, fast heartbeat, and confusion. Most cases are mild or moderate, but some can be more serious. CRS usually happens during the early “step up” doses, often starting a few hours after your infusion and lasting a few days.
To help lower your risk, your care team will follow a “step-up” dosing plan and give you other medications before your infusion and fluids afterward. You’ll get Imdelltra (tarlatamab) at a hospital or clinic where staff can watch you closely and treat CRS right away if it happens. Drink plenty of fluids, and let your care team know right away if you notice any CRS symptoms. If CRS does happen, your oncologist might stop the medication and give you treatment based on how severe your symptoms are.
Imdelltra (tarlatamab) can cause serious nervous system problems, including a condition called immune effector cell-associated neurotoxicity syndrome (ICANS). This can happen as early as the day after your treatment starts or even a few months later, but it usually starts about a month in. Tell your care team right away if you notice symptoms like a headache, numbness or tingling, dizziness, confusion, feeling very sleepy, or having trouble thinking clearly. If you feel different in how you think or stay alert, don’t drive or use heavy machines until you’re feeling normal again.
Imdelltra (tarlatamab) commonly causes lower blood cell counts. Low white blood cells make it harder to fight infections and low platelets raise your risk of bleeding. If you have any unexplained bruising, blood in your urine, blood in your stool, or nosebleeds contact your care team right away. Your oncologist will check your blood counts before each dose and as needed during treatment. If your blood cell levels drop too much, they might pause or stop the medication.
Sometimes, people taking Imdelltra (tarlatamab) developed serious infections such as COVID-19, urinary tract infection (UTI), pneumonia. It’s important to tell your oncologist right away if you have signs or symptoms of an infection such as fever, body aches, chills, cough, or low blood pressure.
Imdelltra (tarlatamab) can raise your liver enzymes, which might be a sign that your liver is irritated or not working properly. Your care team will do blood tests to check your liver before each dose and as needed during treatment. If your liver levels get too high, they might pause or stop your treatment based on how serious it is.Tell your oncologist if you notice signs of liver problems, like yellowing of your skin or eyes, dark urine, or pain in the upper right stomach.
Imdelltra (tarlatamab) can cause severe allergic reactions. Signs can include rash, trouble breathing, or tightness in your chest. Your care team will monitor you during treatment and manage any symptoms if they happen. Depending on how serious the reaction is, your oncologist might pause or permanently stop your treatment.
Based on the way Imdelltra (tarlatamab) works, it might cause harm to an unborn baby. If you’re able to get pregnant, use birth control while taking this medication and for 2 months after the last dose. Let your oncologist know if you’re pregnant or thinking about becoming pregnant while taking Imdelltra (tarlatamab).
The recommended dose of Imdelltra (tarlatamab) follows a step-up schedule to help lower the risk of serious side effects. Once the step-up doses are complete, you’ll get an infusion every 2 weeks. Each treatment cycle lasts 28 days.
Cycle 1
Day 1: 1mg, Day 8: 10mg, Day 15: 10mg
Cycle 2
Day 1: 10mg, Day 15: 10mg
Cycles 3 and 4
Day 1: 10mg, Day 15: 10mg
Cycle 5 and beyond
Day 1: 10mg, Day 15: 10mg
Extensive-stage small cell lung cancer (ES-SCLC) in adults whose cancer has worsened after platinum-based chemotherapy
Metastatic small-cell lung cancer (SCLC) after platinum-based chemotherapy has stopped working
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