Role of Epidemic Tumor Vaccine in Cold Tumors to Hot Tumors

Abstract

Small cell lung cancer (SCLC) is a type of highly aggressive, prone to early metastasis and recurrence, neuroendocrine malignant tumor. The treatment effect of second-line therapy for patients with recurrence/refractory cases is limited, and new therapeutic targets and strategies are urgently needed. Delta-like ligand 3 (DLL3) is abnormally highly expressed on the surface of most SCLC cells, while its expression is limited in normal tissues, making it a promising therapeutic target. The DLL3/CD3 bispecific antibody can redirect T cells to the vicinity of the tumor, inducing the formation of immune synapses, T cell activation, and tumor cell lysis. Tarlatamab, as the first bispecific antibody targeting DLL3/CD3 to enter clinical trials and obtain regulatory approval, has completed the transformation from preclinical validation to key clinical studies. Studies have shown that tarlatamab has durable anti-tumor activity and manageable safety in patients with recurrent/refractory SCLC. This article reviews the biological basis of DLL3, the mechanism of action of DLL3/CD3 bispecific antibodies, as well as the preclinical and clinical research progress of tarlatamab, and assesses its efficacy and safety in heavily treated SCLC. Overall, DLL3/CD3 bispecific antibodies provide a new immunotherapy pathway for recurrent/refractory SCLC, achieving significant clinical relief and survival improvement. Future research needs to further optimize toxicity management, analyze resistance mechanisms, and screen for advantageous populations to promote its precise and sustainable clinical application.