Actually this was an updated analysis from the DeLLphi-304 trial and here we are presenting the outcomes by chemotherapy-free interval and by prior PD-L1 exposure. Basically, the DeLLphi-304 trial was a randomised phase III trial that explored tarlatamab in second-line small cell lung cancer and compared with the physician’s treatment choice - it could be topotecan, amrubicin or also lurbinectedin – in patients that progressed to front-line chemo plus immunotherapy in small cell lung cancer.

So this was a randomised study 1:1 and basically what we presented, the data that we present, was the data by platinum-free interval. What we observed was that those patients with the definition of platinum-resistant disease, that means their chemotherapy-free interval for less than 90 days, those patients presented a median overall survival of 10.9 months for those patients receiving tarlatamab compared with 6.4 months for those patients receiving chemotherapy with a hazard ratio of 0.6 that was in line with the previous data on the advantage of tarlatamab in overall survival in these patients with small cell lung cancer.

Also when you look for those patients with platinum-sensitive disease, that means a chemotherapy-free interval higher than 90 days, we observed that the median overall survival for patients receiving tarlatamab was 17.1 months compared with those who were receiving chemotherapy of 10.6 months. Again, a hazard ratio of 0.65. That means that’s confirming the overall survival benefit for tarlatamab independently of the chemotherapy-free interval and establishes that tarlatamab is the best treatment option in second line for patients with small cell lung cancer.

In this same analysis we also explored, because in some countries for other different reasons some patients did not receive prior anti-PD-L1, that the standard of care in this disease first line should be chemotherapy plus anti-PD1/PD-L1. So we explored those patients that received and did not receive prior anti-PD-L1 exposure. Basically what we observed is that the benefit is independent of if the patients receive anti-PD-L1 or not. The advantage on the median overall survival for those that received tarlatamab 14.1 months compared with 8.3 months for those patients receiving chemotherapy in the group of patients that were exposed to anti-PD-L1 therapy before. For those patients that did not receive anti-PD-L1 in frontline the benefit of tarlatamab was also consistent – a median overall survival of 13.6 months for patients receiving tarlatamab compared with 8.3 months for patients receiving chemotherapy. The hazard ratio, again, 0.65.

So basically what we can conclude is that tarlatamab should be considered the standard of care for almost all patients with second-line small cell lung cancer, including those with historically poor prognoses such as the ones with platinum-resistant disease. So these are the main conclusions of our work presented at ESMO 2025 in Berlin.

What do you think is the clinical significance of these results?

The clinical implications from our study are that, for the first time, we are seeing that patients receiving tarlatamab, although they have platinum-resistant disease, still benefit from an immunotherapy strategy with tarlatamab over chemotherapy. This is the first study to demonstrate that.