Tumor Inflammation-Associated Neurotoxicity Masquerading as Severe Immune Effector Cell-Associated Neurotoxicity Syndrome in a Patient With SCLC Treated With Tarlatamab: A Case Report - PubMed
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- #Case report
- #Small cell lung cancer
- #Neurotoxicity
- Tarlatamab, a delta-like ligand 3-targeting bispecific T-cell engager, shows promise in treating relapsed SCLC.
- A case report describes severe neurotoxicity in a young woman with SCLC and brain metastases after tarlatamab treatment.
- The patient experienced sudden loss of consciousness and seizures 27 hours post tarlatamab dose, meeting grade 4 neurotoxicity criteria.
- Brain imaging showed enlarged metastases with worsened peritumoral edema, and EEG revealed focal epileptiform discharges at the tumor site.
- Symptoms resolved within 36 hours after intensified corticosteroid therapy, and tarlatamab was continued without recurrence of severe neurotoxicity.
- The event was identified as Tumor Inflammation-Associated Neurotoxicity (TIAN), not Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS).
- TIAN presents severe but reversible symptoms mimicking high-grade ICANS, requiring differentiation for proper management.
- Recognizing TIAN is crucial for individualized therapy decisions under careful monitoring.