Would you continue tarlatamab in CNS-only progression of small cell cancer if there is no systemic disease?

I would absolutely continue tarlatamab in this scenario. While there is evidence of at least some activity of tarlatamab in the CNS (e.g., Zhang et al., PMID 40126456), the effect can be transient, suggesting that intra- and extracranial discrepancy is possible/probable. I would handle isolated, oli...

If the patient is otherwise doing well and tolerating treatment well, in the setting of isolated progression, I would consider continuing tarlatamab and managing the CNS progression with radiation. I have treated a patient in this scenario, who is clinically doing well with subsequent resolution of ...

There are no data to guide this particular scenario, but if the patient is tolerating tarlatamab well and the only site of progression is intracranial, it may be reasonable to treat the intracranial disease with local therapy, while continuing tarlatamab. Interestingly, there is 1 case report of int...

Yes, I would, since the extra-cranial disease is well controlled. I would treat the brain lesion with SRS while continuing tarlatamab. While tarlatamab has intracranial activity based on the recent update from the DeLLphi-304 trial (Mountzios et al., ASCO 2026), this scenario suggests that the patie...