학술논문

DLL3-guided therapies in small-cell lung cancer: from antibody-drug conjugate to precision immunotherapy and radioimmunotherapy
Document Type
Report
Source
Molecular Cancer. May 10, 2024, Vol. 23 Issue 1
Subject
United States
Language
English
ISSN
1476-4598
Abstract
DLL3 acts as an inhibitory ligand that downregulates Notch signaling and is upregulated by ASCL1, a transcription factor prevalent in the small-cell lung cancer (SCLC) subtype SCLC-A. Currently, the therapeutic strategies targeting DLL3 are varied, including antibody-drug conjugates (ADCs), bispecific T-cell engagers (BiTEs), and chimeric antigen receptor (CAR) T-cell therapies. Although rovalpituzumab tesirine (Rova-T) showed promise in a phase II study, it failed to produce favorable results in subsequent phase III trials, leading to the cessation of its development. Conversely, DLL3-targeted BiTEs have garnered significant clinical interest. Tarlatamab, for instance, demonstrated enhanced response rates and progression-free survival compared to the standard of care in a phase II trial; its biologics license application (BLA) is currently under US Food and Drug Administration (FDA) review. Numerous ongoing phase III studies aim to further evaluate tarlatamab's clinical efficacy, alongside the development of novel DLL3-targeted T-cell engagers, both bispecific and trispecific. CAR-T cell therapies targeting DLL3 have recently emerged and are undergoing various preclinical and early-phase clinical studies. Additionally, preclinical studies have shown promising efficacy for DLL3-targeted radiotherapy, which employs [beta]-particle-emitting therapeutic radioisotopes conjugated to DLL3-targeting antibodies. DLL3-targeted therapies hold substantial potential for SCLC management. Future clinical trials will be crucial for comparing treatment outcomes among various approaches and exploring combination therapies to improve patient survival outcomes. Keywords: DLL3, Small-cell lung cancer, Antibody-drug conjugate, T-cell engager, Radioimmunotherapy
Author(s): Po-Lan Su[sup.1,2] , Karthik Chakravarthy[sup.1,3] , Naoki Furuya[sup.1,4] , Jeremy Brownstein[sup.5] , Jianhua Yu[sup.6] , Meixiao Long[sup.3,7] , David Carbone[sup.1,3] , Zihai Li[sup.1,3] and Kai He[sup.1,3] Correspondence Small-cell lung [...]