Study of Datopotamab Deruxtecan (Dato-DXd) in Combination With Durvalumab and Carboplatin for First-Line Treatment of Patients With Advanced NSCLC Without Actionable Genomic Alterations

This is a Phase III, randomized, open-label, multicenter, global study to compare the efficacy and safety of Datopotamab Deruxtecan (Dato-DXd) in combination with durvalumab and carboplatin compared with pembrolizumab in combination with histology-specific platinum-based chemotherapy as first-line treatment of adults with stage IIIB, IIIC, or IV NSCLC without actionable genomic alterations (including sensitizing EGFR mutations, and ALK and ROS1 rearrangements).

Inclusion:Participants ≥ 18 years at screeningParticipants with histologically or cytologically documented NSCLC that is Stage IIIB or IIIC disease not amenable for surgical resection or definitive chemoradiation or Stage IV metastatic NSCLC disease at the time of randomisation, who have not received prior chemotherapy or other systemic therapy for first-line Stage IIIB, IIIC or IVLacks sensitising EGFR tumour tissue mutation and ALK and ROS1 rearrangements and has no documented tumour genomic alterations in NTRK, BRAF, RET, MET or other actionable driver oncogenes with approved therapies (actionable genomic alterations).ECOG PS of 0 or 1Archival tumour tissue collected prior to signing of ICFHas adequate bone marrow reserve and organ function within 7 days before randomisationExclusion:History of another primary malignancy except for malignancy treated with curative intent with no known active disease within 3 years before the first dose of study intervention and of low potential risk for recurrenceMixed small-cell lung cancer and NSCLC histology; sarcomatoid variant of NSCLCPersistent toxicities caused by previous anti-cancer therapy not yet improved to Grade ≤ 1 or baseline (with exceptions)Active or prior documented autoimmune, connective tissue or inflammatory disorders (with exceptions)Spinal cord compression or brain metastases unless asymptomatic, stable, not requiring steroids for at least 7 days prior to randomisation, and a minimum of 2 weeks have elapsed between the end of radiotherapy and study enrollmentHistory of leptomeningeal carcinomatosisClinically significant corneal diseaseKnown active or uncontrolled hepatitis B or C virus infectionKnown HIV infection that is not well controlledHistory of non-infectious ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at screening