Tarlatamab–targeting the delta-like ligand 3 (DLL3) heavily expressed on small cell lung cancer cells–has been FDA-approved since May 2024 as second-line therapy following platinum-based chemotherapy for extensive-stage SCLC based on impressive survival outcomes in a phase 2 trial. The follow-on large international phase 3 DeLLphi-304 trial confirmed significantly longer median survival with second-line tarlatamab (13.6 months) than with the second-line standard for the enrolling country (8.3 months). The latter was mostly topotecan (73%), but also included lurbinectedin (18%) as given in the US and amrubicin (9%) as given in Japan, none of which have independently achieved median survival times surpassing 9 months. | Mountzios, N Engl J Med 2025
