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Phase III, Open-label, Study of First-line Dato-DXd in Combination With Rilvegostomig for Advanced Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations

RecruitingPhase 3

A Phase III, Randomised, Open-label, Global Study of Datopotamab Deruxtecan (Dato-DXd) in Combination With Rilvegostomig or Rilvegostomig Monotherapy Versus Pembrolizumab Monotherapy for the First-line Treatment of Participants With Locally-advanced or Metastatic Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations (TROPION-Lung10)

Who can join

Ages 18 and older · All sexes

Full eligibility criteria
Inclusion Criteria:

* Histologically or cytologically documented non-squamous NSCLC.
* Stage IIIB or IIIC or Stage IV metastatic NSCLC (according to Edition 8 of the AJCC staging manual) not amenable to curative surgery or definitive chemoradiation.
* Absence of sensitising EGFR mutations, and ALK and ROS1 rearrangements, and absence of documented local test result for any other known genomic alteration for which there are locally approved and available targeted first-line therapies.
* Must provide tumor sample to determine PD-L1 status, TROP2 status and other biomarkers.
* Known tumour PD-L1 expression status defined as TC ≥ 50%
* At least one lesion, not previously irradiated that qualifies as a RECIST 1.1 target lesion at baseline
* ECOG performance status of 0 or 1
* Adequate bone marrow reserve and organ function

Exclusion Criteria:

* Prior systemic therapy for advanced/metastatic NSCLC.
* Squamous cell histology, or predominantly squamous cell histology NSCLC; mixed small cell lung cancer; NSCLC histology, sarcomatoid variant.
* History of another primary malignancy within 3 years
* Active or prior documented autoimmune or inflammatory disorders (with exceptions)
* Any evidence of severe or uncontrolled disease that makes it undesirable for the participant to participate in the study or that would jeopardies compliance with the protocol.
* Has clinically significant third-space fluid retention (for example pleural effusion) and is not amenable for repeated drainage.
* History of any ILD/pneumonitis, including radiation pneumonitis (apart from radiation pneumonitis that did not require steroids), or drug-induced ILD/pneumonitis, has current or suspected ILD/pneumonitis that cannot be ruled out by imaging at screening.
* Has significant pulmonary function compromise, as determined by the investigator
* Spinal cord compression, or brain metastases unless participant treated and no longer symptomatic, radiologically stable, and who require no treatment with corticosteroids or anticonvulsants.
* History of leptomeningeal carcinomatosis
* Known clinically significant corneal disease
* Active infection with TB, HBV, HCV, Hepatitis A, or known HIV infection that is not well controlled
* History of active primary immunodeficiency

About the study

The purpose of this study is to evaluate efficacy and safety of Dato-DXd in combination with rilvegostomig or rilvegostomig monotherapy compared with pembrolizumab monotherapy as a first line therapy in participants with locally advanced or metastatic non-squamous NSCLC with high PD-L1 expression (TC ≥ 50%) and without actionable genomic alterations.

What is being tested

Sponsor: AstraZeneca · Participants: 675 · Started: Apr 11, 2024

Contact the study team

Official record on ClinicalTrials.gov — NCT06357533

Locations in the U.S.

AlaskaResearch Site, Anchorage
ArizonaResearch Site, Tucson
ArkansasResearch Site, Little Rock
Research Site, Springdale
CaliforniaResearch Site, Anaheim
Research Site, Beverly Hills
Research Site, Fountain Valley
FloridaResearch Site, Clermont
Research Site, Gainesville
Research Site, Miami Beach
Research Site, Orange City
Research Site, Orlando
Research Site, West Palm Beach
GeorgiaResearch Site, Atlanta
Research Site, Atlanta
IllinoisResearch Site, Hinsdale
IndianaResearch Site, Noblesville
KentuckyResearch Site, Paducah
MarylandResearch Site, Annapolis
MassachusettsResearch Site, Boston
Research Site, Boston
MichiganResearch Site, Dearborn
Research Site, Farmington Hills
Research Site, Grand Rapids
MississippiResearch Site, Hattiesburg
MissouriResearch Site, Kansas City
NebraskaResearch Site, Grand Island
Research Site, Omaha
NevadaResearch Site, Las Vegas
New YorkResearch Site, Stony Brook
North CarolinaResearch Site, Greenville
Research Site, Salisbury
OhioResearch Site, Cincinnati
Research Site, Maumee
Research Site, Toledo
South CarolinaResearch Site, Greenville
South DakotaResearch Site, Sioux Falls
TexasResearch Site, Fort Worth
Research Site, Houston
Research Site, Kingwood
Research Site, Odessa
VirginiaResearch Site, Fort Belvoir
Research Site, Leesburg
Research Site, Midlothian
Research Site, Richmond
WashingtonResearch Site, Tacoma
Research Site, Vancouver
Research Site, Wenatchee
WisconsinResearch Site, Appleton

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.