Study of Dato-DXd Plus Pembrolizumab vs Pembrolizumab Alone in the First-line Treatment of Subjects With Advanced or Metastatic NSCLC Without Actionable Genomic Alterations

Running, not enrolling · Phase 3

Conditions studied: Metastatic Non Small Cell Lung Cancer

In brief

This study is designed to assess the efficacy and safety of datopotamab deruxtecan (Dato-DXd) in combination with pembrolizumab versus pembrolizumab alone in participants with advanced or metastatic non-small cell lung cancer (NSCLC) of non-squamous histology.

Key facts

Study ID

NCT05215340

Run by

Daiichi Sankyo

People needed

740

Starts

2022-03-04

Expected to finish

2032-03-04

Last updated by the study team

2026-06-12

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Participants eligible for inclusion in the study must meet all inclusion criteria within 28 days of randomization into the study.
• Sign and date the Tissue Screening and Main Informed Consent Forms, prior to the start of any study-specific qualification procedures.
• Adults ≥18 years or the minimum legal adult age (whichever is greater) at the time of informed consent.
• Histologically documented non-squamous NSCLC that meets all of the following criteria (Note: Subjects with squamous histology were eligible prior to Protocol Version 5.0. After Protocol Version 5.0, subjects with squamous histology are not eligible. Subjects with mixed histology, including those with a squamous component, remain eligible the study even after Protocol Version 5.0):
• Stage IIIB or IIIC disease and not candidates for surgical resection or definitive chemoradiation, or Stage IV NSCLC disease at the time of randomization (based on the American Joint Committee on Cancer, Eighth Edition). Participants with early-stage NSCLC who have relapsed should be restaged during screening to ensure their eligibility for the study.
• Documented negative test results for epidermal growth factor receptor (EGFR), lymphoma kinase (ALK), and proto-oncogene1 (ROS1) actionable genomic alterations (AGAs) based on analysis of tumor tissue. If test results for EGFR, ALK, and ROS1 are not available, subjects are required to undergo testing performed locally for these genomic alterations.
• No known AGAs in neurotrophic tyrosine receptor kinase (NTRK), proto-oncogene B-raf (BRAF), rearranged during transfection (RET), mesenchymal-epithelial transition factor (MET), or other actionable driver kinases with locally approved therapies. (Testing for genomic alterations besides EGFR, ALK, and ROS1 is not required prior to randomization). Subjects whose tumors harbor KRAS mutations are eligible for the study.
• Has provided a formalin-fixed tumor tissue sample for the measurement of trophoblast cell surface protein 2 (TROP2) protein expression and for the assessment of other exploratory biomarkers.
• Tumor has high programmed death receptor-1 (PD-L1) expression (TPS ≥50%) as determined by PD-L1 immunohistochemistry (IHC) 22C3 pharmDx assay by central testing (minimum of 6 slides).
• Has an adequate treatment washout period before Cycle 1 Day 1.
• Measurable disease based on local imaging assessment using RECIST Version 1.1.
• Has left ventricular ejection fraction (LVEF) ≥50% by either an echocardiogram (ECHO) or multigated acquisition scan (MUGA) within 28 days before randomization.
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 at screening.
• Has a life expectancy of at least 3 months.
• Adequate bone marrow function within 7 days before randomization.

You may not qualify if…

• Has received prior systemic treatment for advanced or metastatic NSCLC.
• Has received prior treatment for NSCLC with any of the following, including in the adjuvant/neoadjuvant setting:
• Any agent, including an antibody-drug conjugate, containing a chemotherapeutic agent targeting topoisomerase I.
• TROP2-targeted therapy.
• Any anti-programmed death receptor-1 (PD-1), anti-PD-L1, or anti-PD-ligand 2 (L2) agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX40, CD137).
• Any other immune checkpoint inhibitors. Participants who received adjuvant or neoadjuvant therapy OTHER than those listed above, are eligible if the adjuvant/neoadjuvant therapy was completed at least 6 months prior to the diagnosis of advanced/metastatic disease.
• Has spinal cord compression or active and untreated central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases and who are asymptomatic may participate provided they are radiologically stable.
• Has received prior radiotherapy < 4 weeks of start of study intervention or more than 30 Gy (unit of ionizing radiation dose in the International System of Units) to the lung within 6 months of Cycle 1 Day 1.
• History of another primary malignancy (beyond NSCLC) except for:
• Malignancy treated with curative intent and with no known active disease ≥3 years before the first dose of study treatment and of low potential risk for recurrence.
• Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease.
• Adequately treated carcinoma in situ without evidence of disease.
• Participants with a history of prostate cancer (tumor/node/metastasis stage) of Stage ≤T2cN0M0 without biochemical recurrence or progression and who in the opinion of the Investigator are not deemed to require active intervention.
• Has a history of (non-infectious) interstitial lung disease (ILD)/pneumonitis including radiation pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening.
• Clinically severe pulmonary compromise, as judged by the investigator, resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder, or any autoimmune, connective tissue or inflammatory disorders with pulmonary involvement or prior complete pneumonectomy.
• Uncontrolled or significant cardiovascular disease, including:
• Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) interval >470 ms regardless of sex (based on the average of the 12-lead electrocardiogram determination at screening).
• Myocardial infarction within 6 months prior to randomization.
• Uncontrolled angina pectoris within 6 months prior to randomization.
• LVEF <50% by ECHO or MUGA scan within 28 days before randomization.
• New York Heart Association Class 2 to 4 congestive heart failure (CHF) at screening.
• Uncontrolled hypertension (resting systolic blood pressure >180 mmHg or diastolic blood pressure >110 mmHg) within 28 days before randomization.
• Participants with a history of Class 2 to 4 CHF prior to screening, must have returned to Class 1 CHF and have LVEF ≥50% (by either an ECHO or MUGA scan within 28 days before randomization) in order to be eligible.
• Clinically significant corneal disease.
• Has received a live vaccine or live-attenuated vaccine (messenger ribonucleic acid and replication-incompetent adenoviral vaccines are not considered attenuated live vaccines) within 30 days prior to the first dose of study drug. For any participant receiving an approved severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccine, please follow the vaccine label and/or local guidance.

Where it is running

• Ironwood Cancer and Research Center — Chandler, Arizona, United States
• UCLA HemOnc - Clinical Research Unit — Los Angeles, California, United States
• Ridley-Tree Cancer Center — Santa Barbara, California, United States
• PIH Health Whittier Hospital — Whittier, California, United States
• The Oncology Institute of Hope and Innovation — Whittier, California, United States
• Uch-Mhs D/B/A Memorial Health System — Colorado Springs, Colorado, United States
• Johns Hopkins University — Baltimore, Maryland, United States
• American Oncology Partners of Maryland — Bethesda, Maryland, United States
• Dana-Farber Cancer Institute — Boston, Massachusetts, United States
• Beth Israel Deaconess Medical Center — Boston, Massachusetts, United States
• Dana Farber Cancer Institute - Foxborough — Foxborough, Massachusetts, United States
• DFCI - South Shore Hospital — South Weymouth, Massachusetts, United States
• Dartmouth Hitchcock Medical Center — Lebanon, New Hampshire, United States
• Astera Cancer Care — East Brunswick, New Jersey, United States
• Regional Cancer Care Associates LLC — Freehold, New Jersey, United States
• Cooperman Barnabas Medical Center — New Brunswick, New Jersey, United States
• The Valley Hospital — Paramus, New Jersey, United States
• Montefiore Medical Center — The Bronx, New York, United States
• Arizona Oncology NAHOA — Irving, Texas, United States
• Cancer Care Center of Brevard — Irving, Texas, United States
• Illinois Cancer Specialists — Irving, Texas, United States
• Maryland Oncology Hematology — Irving, Texas, United States
• Southern Cancer Center — Irving, Texas, United States
• Texas Oncology - Northeast Texas — Irving, Texas, United States
• Institut Bergonie — Bordeaux, France

Full record on ClinicalTrials.gov

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