Tarlatamab in Small-Cell Lung Cancer

To the Editor: The DeLLphi-304 trial reported by Mountzios et al. (July 24 issue) 1 represents a landmark step forward for the treatment of relapsed small-cell lung cancer. The delta-like ligand 3 (DLL3)–targeted bispecific T-cell engager tarlatamab showed a significant overall survival benefit as second-line treatment as compared with standard chemotherapy in the trial. This innovative approach offers renewed hope in the treatment of a condition with historically limited second-line options. However, a key methodologic issue merits attention. Approximately 25% of the patients in the chemotherapy group had a chemotherapy-free interval of 180 days or more after first-line platinum-based therapy. According . . .