New combo therapy targets aggressive lung cancer transformation

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Histologically confirmed SCLC and no prior systemic treatment for SCLC 2. Patient initially diagnosed with activating EGFR mutation (L858R, Del 19) and treated with any kind of EGFR TKI. 3. Confirmed SCLC transformation right after EGFR TKI treatment failure. 4. Age ≥19 years 5. ECOG performance status of 0 to 1 6. Had at least one measurable lesion. 7. Adequate organ function * Absolute neutrophil count ≥ 1.5 x 109/L * Platelet count ≥ 100 x 109/L * Hemoglobin ≥ 9 g/dL * Estimated glomerular filtration rate based on Modification of Diet in Renal Disease calculation \> 30 mL/min/1.73 m2 * Aspartate aminotransferase and alanine aminotransferase ≤ 3 x upper limit of normal (ULN) (or ≤ 5 x ULN for subjects with liver involvement) * Total bilirubin ≤ 1.5 x ULN (or ≤ 2 x ULN for subjects with liver metastases) * Prothrombin time (PT)/international normalized ratio and partial thromboplastin time or activated partial thromboplastin time ≤ 1.5 x institutional ULN Note: Subjects on stable anticoagulation therapy are allowed. 8. Pulmonary function: No clinically significant pleural effusion at the timepoint of screening. Pleural effusion with no significant symptom is allowed for enrollment. 9. Cardiac function: Cardiac ejection fraction ≥ 50% 10. Female subjects must either be of non-reproductive potential 11. Female subject with reproductive potential can be enrolled with agreement to following guidance. * subject uses contraception during treatment and through 60 days after receiving last dose of tarlatamab or for 6 months after last dose of carboplatin and/or etoposide and 5 months after last dose of atezolizumab. 12. Subject is willing and able to comply with the protocol 13. Signed written informed consent Exclusion Criteria: 1. Treated with additional chemotherapy after confirmed with transformed SCLC. 2. Previously exposed to the immune checkpoint inhibitor treatment. 3. Untreated symptomatic brain metastases or leptomeningeal disease. * Asymptomatic brain metastases can be enrolled per investigator decision 4. Uncontrolled systemic illness including uncontrolled hypertension, active bleeding, or active infection. 5. Past medical history of interstitial lung disease, drug induced interstitial lung disease, radiation pneumonitis which required steroid treatment, active non- infectious pneumonitis 6. Active or prior documented autoimmune or inflammatory disorders 7. Myocardial infarction and/or symptomatic congestive heart failure (New York Heart Association \> class II) within 6 months prior to first dose of study treatment 8. History of solid organ transplant. 9. Major surgical procedures within 28 days prior to first dose of study treatment. 10. History of allergic reactions or acute hypersensitivity reactions to antibody therapies, platinum chemotherapy, or etoposide. 11. Disagree to the guidance of contraception during the study.