Tarlatamab usage and dosage: recommended dosage, special populations and delayed dosing dosage adjustments

Tarlatamab (Tarlatamab) needs to be customized. Patients should infuse Tarlatamab under the guidance of a doctor, and the dose must not be changed without authorization.

Recommended dose of Tarlatamab for adults

1. Week 1

(1) Day 1: Increasing dose of 1 mg Tarlatamab intravenous injection.

(2) Day 8: 10 mg of talatumumab intravenously.

(3) Day 15: 10 mg of talatumumab intravenously.

2. Week 2

Days 1 and 15: 10 mg of talatumumab intravenously

3. Weeks 3 and 4

Days 1 and 15: 10 mg of talatumumab intravenously

4. Week 5 and subsequent infusions

10 mg of talatumumab intravenously.

5. Duration of treatment

After the ascending dosing schedule of talatumumab, it will be administered every 2 weeks until disease progression or unacceptable toxicity occurs.

Tarlatamab (Tarlatamab) liver and kidney dose adjustment

1. Renal dose adjustment

(1) Mild and moderate renal insufficiency: It is not recommended to adjust the tarlatamab dose.

(2) Severe renal insufficiency: data not available.

2. Liver dose adjustment

(1) Mild and moderate hepatic insufficiency: It is not recommended to adjust the dose of talatumumab.

(2) Severe hepatic insufficiency: data not available.

3. Hepatotoxicity dose adjustment

(1) Grade 3 elevation of ALT or AST or bilirubin: suspend talatumumab until improvement to grade 1 or lower.

(2) Grade 4 elevation of ALT or AST or bilirubin: Permanently discontinue talatumumab treatment.

(3) When AST or ALT is greater than 3x the upper limit of normal (ULN), and total bilirubin is greater than 2xULN in the absence of other reasons, permanently discontinue talatumumab treatment.

Tarlatamab delayed dose adjustment

1. The last dose is 1 mg on day 1 of cycle 1

(1) Delay of 14 days or less: 10 mg administered, and then resume according to the dosage schedule.

(2) More than 14 days: Give an increasing dose of 1 mg. If tolerated, increase to 10 mg after one week and then resume planned dosage regimen.

2. The last dose is 10mg on day 8 of cycle 1

(1) Delay: 21 days or less: administer 10mg, then resume the planned dosage regimen.

(2) More than 21 days: Give an increasing dose of 1mg. If tolerated, increase to 10 mg after one week and then resume planned dosage regimen.

3. The final dose is 10 mg on day 15 of cycle 1, and every 2 weeks thereafter

(1) Delay: 28 days or less: administer 10 mg, and then resume the planned dosage regimen.

(2) More than 28 days: Give an increasing dose of 1 mg. If tolerated, increase to 10 mg after one week and then resume planned dosage regimen.