Barw Barw Medical Journal 2960-1959 2025 12 10 Small Cell Lung Cancer and Tarlatamab: A Meta-Analysis of Clinical Trials 42 51 10.58742/bmj.v4i1.216 eng Rebaz M. Ali Department of Oncology, Hiwa Cancer Hospital, Shorsh Street, Sulaymaniyah, Iraq. rebaz.ali12@gmail.com Sadraldin A. Braim Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. Sadraldin.Braim@gmail.com Bilal T. Mohammed Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. bilal.mohammed@gmail.com Shiraz K. Mohammed Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. Shiraz.Mohammed@gmail.com Maria A. Rasool Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. maria.rasool@gmail.com Shadan A. Hamad Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. shadan.hamad@gmail.com Zanyar K. Hama Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. zanyar12@gmail.com Mohammed Q. Mustafa Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary. mohammed.mustafa@gmail.com Kayhan A. Najar Department of Gastroenterology and Hepatology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. kayhan.najar@gmail.com Sasan M. Ahmed Green Apple Organization for Health Awareness, Hamdi Street, Azadi Mall, Sulaymaniyah, Iraq. sasan0751@gmail.com Karukh K. Mohammed Smart Health Tower (Raparin Branch), Karux Street, Rania, Iraq. karukh.mohammed@gmail.com Berun A. Abdalla Department of Scientific Affairs, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. berun.anwer95@gmail.com 2025 09 20 Introduction Tarlatamab is a Delta-like ligand 3 (DLL3) -directed bispecific T-cell engager recently approved for use in patients with advanced small cell lung cancer (SCLC) after progression on platinum-based therapy. This meta-analysis evaluated the efficacy and safety of tarlatamab as monotherapy and in combination regimens in the treatment of SCLC. Methods A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE and EMBASE were searched from inception through September 2025 to identify clinical trials evaluating tarlatamab in SCLC. Eligible studies reported quantifiable efficacy and/or safety outcomes. Random-effects models were used to pool objective response rate (ORR) and disease control rate (DCR), and Kaplan–Meier methods were applied to assess survival outcomes. Results Seven clinical trials involving 1,247 patients with advanced SCLC were included. The pooled ORR was 0.42 (95% CI 0.31–0.54), with response rates ranging from 21–47% in monotherapy studies and up to 48% in combination regimens. Across six studies, pooled DCR was 0.48 (95% CI 0.31–0.66), with DCR reaching up to 87% in combination settings. Median progression-free survival ranged from 3.5 to 5.6 months, while median overall survival ranged from 13.2 to 25.3 months. Pooled time-to-event analyses demonstrated significant reductions in the risk of disease progression and death. Grade 3 and grade 4 adverse events occurred in 5.4% and 1.4% of patients, respectively, although safety reporting was incomplete in several studies. Conclusion Tarlatamab demonstrates clinically meaningful antitumor activity with an acceptable safety profile in heavily pretreated SCLC. These findings support DLL3-targeted therapy as a promising treatment strategy and warrant further prospective studies to define its optimal role in the evolving SCLC treatment landscape.