85 www.ReadMPM.com | www.MountPleasantMagazine.com | www.MountPleasantPodcast.com A cancer diagnosis of any kind can be devastating. In terms of lung cancer, a diagnosis of small cell lung cancer is especially so, as the disease has a poor prognosis. It can be hard to detect and spreads easily, making it complicated to treat. But to paraphrase South Carolina’s state motto, “Where there is breath there is hope,” and hope recently got much brighter with a new treatment available at MUSC Hollings Cancer Center. The words ‘bi-specific T-cell engager,’ (BiTE), may not mean much to those outside the medical field, but this type of targeted therapy, known as tarlatamab, is a game changer for small cell lung cancer patients whose cancer has not responded — or has stopped responding — to frontline treatments like chemotherapy. “Think of BiTE therapy as having two arms and two targets; one arm grabs the T-cell — or immune cell — and the other arm grabs the cancer cell. Then it brings the two together so the immune cell can kill the cancer cell,” explained Dr. Mariam Alexander, an oncologist with MUSC Hollings Cancer Center. She served as the site leader for part of the clinical trials of tarlatamab, an anti-cancer medication which was approved by the Food and Drug Administration this summer. The treatment is administered through an intravenous line and spreads through the bloodstream, allowing the tarlatamab to attach wherever the cancerous DLL3 cells have spread throughout the body. Small cell lung cancer only accounts for about 15% of lung cancer diagnoses, but unlike non-small cell lung cancer, which can often be treated with surgery if caught early, small cell lung cancer is fast growing, and available treatments are not known to last. “Small cell lung cancer must be treated with chemo and immunotherapy if it’s caught at an early stage. But it’s rarely caught at an early stage; more often, it’s diagnosed after it has spread,” said Alexander. She added that while small cell lung cancer initially responds well to chemotherapy, the response isn’t ‘durable,’ an oncology term for a treatment that lasts. Following chemo, she said that some patients continue to respond to immunotherapy, but most patients do not, and the cancer returns months later. “What they’re seeing with tarlatamab is a durable response, so patients who are responding continue to respond for a long time, and it doesn’t have the toxicities of chemotherapy,” Alexander explained. “It is really great that this therapy has been approved, because patients with small cell lung cancer don’t have many options.” Breath of Hope Small cell lung cancer takes a big step forward BY ANNE TOOLE health & wellness Dr. Mariam Alexander.
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