Chemotherapy and immunotherapy combined with surgery is the standard treatment for patients with early-stage resectable non-small cell lung cancer (NSCLC), but many still experience disease recurrence.
In the Phase II NeoCOAST-2 trial led by Tina Cascone, M.D., Ph.D., researchers enrolled patients with untreated, resectable stage IIA-IIIB NSCLC and examined the efficacy and safety of pre-surgical chemotherapy plus durvalumab immunotherapy in combination with novel monoclonal antibodies oleclumab or monalizumab or with the antibody-drug conjugate datopotamab deruxtecan (Dato-DXd). Of participants who received oleclumab, 15 of 74 (20.3%) had a pathological complete response (pCR) – absence of residual tumor at surgery – and 31 of 74 (41.9%) had a major pathological response (mPR) – 10% or less residual tumor at surgery. In the monalizumab arm, 18 of 70 (25.7%) had a pCR and 35 of 70 (50%) had an mPR. In the Dato-DXd arm, 19 of 54 (35.2%) had a pCR and 34 of 54 (63%) had an mPR. Overall, the combinations were well tolerated and had no adverse impacts on surgery. The results highlight the potential benefits of adding novel agents, including Dato-DXd, to pre-surgical chemo-immunotherapy to improve outcomes for patients with early NSCLC.