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**obrixtamig + carboplatin + etoposide** is an investigational combination regimen designed for the treatment of delta-like ligand 3 (DLL3)-positive neuroendocrine tumors, principally small cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC-L), and extrapulmonary neuroendocrine carcinoma (epNEC). Obrixtamig (BI 764532, HPN328) is a bispecific, IgG-like T-cell engager antibody that targets DLL3 on tumor cells and CD3 on T-cells, facilitating T-cell-mediated cytotoxicity against DLL3-expressing tumor cells. Carboplatin and etoposide are established cytotoxic chemotherapeutic agents: carboplatin is a platinum-based DNA-damaging agent, while etoposide inhibits topoisomerase II, leading to DNA strand breaks and apoptosis. The triple regimen is under investigation in trials for DLL3-positive neuroendocrine malignancies, with obrixtamig providing immune-mediated, targeted killing and carboplatin/etoposide delivering broad cytotoxic activity.
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