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 (TROPION-Lung08)
Metastatic Non Small Cell Lung Cancer
About this trial
This is an interventional treatment trial for Metastatic Non Small Cell Lung Cancer focused on measuring Metastatic Non Small Cell Lung Cancer, Advanced Non Small Cell Lung Cancer, Datopotamab Deruxtecan (Dato-DXd), Pembrolizumab
Eligibility Criteria
Inclusion Criteria:
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 NSCLC that meets all of the following criteria:
- 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).
- Documented negative test results for epidermal growth factor receptor (EGFR), lymphoma kinase (ALK), and proto-oncogene1 (ROS1) actionable genomic alterations based on analysis of tumor tissue.
- No known actionable genomic alterations 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.
- 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.
Exclusion Criteria:
- Has received prior systemic treatment for advanced or metastatic NSCLC.
Has received prior treatment 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 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 that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening.
- Clinically severe pulmonary compromise 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 msec 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 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.
- Active, known, or suspected autoimmune disease (has an active autoimmune disease that has required systemic treatment in the past 2 years).
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosage >10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy ≤7 days prior to the first dose of study drug.
- Has known human immunodeficiency virus (HIV) infection that is not well controlled.
- Has an active hepatitis or uncontrolled hepatitis B or active hepatitis C infection; is positive for hepatitis B or C virus based on the evaluation of results of tests for hepatitis B (hepatitis b surface antigen, anti-HBs, anti-HBc, or hepatitis B virus [HBV] DNA) or hepatitis C virus (HCV RNA) infection.
- Has an uncontrolled infection requiring IV antibiotics, antivirals, or antifungals.
- Had an allogeneic tissue/solid organ transplant.
- Has a history of severe hypersensitivity reactions to either the drug substances or inactive ingredients (including but not limited to polysorbate 80) of Dato-DXd or pembrolizumab.
Sites / Locations
- Ironwood Cancer and Research CenterRecruiting
- UCLA HemOnc - Clinical Research UnitRecruiting
- Compassionate Cancer Care Medical GroupRecruiting
- UCSF Helen Diller Family Comprehensive Cancer CenterRecruiting
- Ridley-Tree Cancer CenterRecruiting
- PIH Health Whittier HospitalRecruiting
- The Oncology Institute of Hope and InnovationRecruiting
- Uch-Mhs D/B/A Memorial Health SystemRecruiting
- Johns Hopkins UniversityRecruiting
- American Oncology Partners of MarylandRecruiting
- Dana-Farber Cancer InstituteRecruiting
- Dartmouth Hitchcock Medical CenterRecruiting
- Astera Cancer CareRecruiting
- Regional Cancer Care Associates LLCRecruiting
- Cooperman Barnabas Medical CenterRecruiting
- The Valley HospitalRecruiting
- Montefiore Medical CenterRecruiting
- Arizona Oncology NAHOARecruiting
- Cancer Care Center of BrevardRecruiting
- Maryland Oncology HematologyRecruiting
- Southern Cancer CenterRecruiting
- Texas Oncology - Northeast TexasRecruiting
- Texas Oncology Gulf CoastRecruiting
- Texas Oncology McAllenRecruiting
- University of Texas Health Science Center San AntonioRecruiting
- Utah Cancer SpecialistsRecruiting
- Providence Regional Cancer SystemRecruiting
- Medical College of WisconsinRecruiting
- Fundacion CENIT para la investigación en NeurocienciasRecruiting
- Centro de Investigación Pergamino S. A.Recruiting
- Instituto de Oncología de RosarioRecruiting
- Sanatorio ParqueRecruiting
- Sanatorio Británico de RosarioRecruiting
- Clinica Viedma SARecruiting
- Austin HospitalRecruiting
- Peninsula and South Eastern Haematology and Oncology GroupRecruiting
- Chris Obrien LifehouseRecruiting
- The Queen Elizabeth HospitalRecruiting
- Onze-Lieve-Vrouwziekenhuis Olvz - Campus AalstRecruiting
- Grand Hopital de Charleroi - Hopital Saint JosephRecruiting
- Az Maria Middelares - Campus Maria MiddelaresRecruiting
- AZ NikolaasRecruiting
- Instituto de Pesquisas em Saúde - IPSRecruiting
- Oncosite - Centro de Pesquisa Clinica OncologiaRecruiting
- UPCO - Unidade de Pesquisas Clínicas em Oncologia - Clinica LacksRecruiting
- Santa Casa de Misericordia de Porto AlegreRecruiting
- Instituto Nacional de Câncer - INCARecruiting
- Centro de Estudos e Pesquisa de Hematologia e Oncologia - CEPHORecruiting
- Instituto de Ensino e Pesquisas Sao LucasRecruiting
- Santa Cabrini HospitalRecruiting
- Centro de Estudios Clínicos SAGARecruiting
- OncovidaRecruiting
- Fundación Arturo Pérez LópezRecruiting
- Centro de Investigaciones Clinicas Vina Del MarRecruiting
- Guangxi Medical University Affiliated Tumor HospitalRecruiting
- Henan Cancer HospitalRecruiting
- Jilin Cancer HospitalRecruiting
- Peking University Peoples HospitalRecruiting
- Peking University Cancer HospitalRecruiting
- Hunan Cancer HospitalRecruiting
- Affiliated Cancer Hospital and Institute of Guangzhou Medical UniversityRecruiting
- Haikou People's HospitalRecruiting
- The First Affiliated Hospital of College of Medicine Zhejiang UniversityRecruiting
- Zhejiang Cancer Hospital
- Harbin Medical University Cancer HospitalRecruiting
- Inner Mongolia Medical University- the Affiliated HospitalRecruiting
- Jiamusi Tumor and Tuberculosis HospitalRecruiting
- Yunnan Cancer HospitalRecruiting
- Linyi Cancer HospitalRecruiting
- The First Affiliated Hospital of Nanchang UniversityRecruiting
- Jiangsu Province HospitalRecruiting
- The Second People's Hospital of NeijiangRecruiting
- Fudan University Shanghai Cancer CenterRecruiting
- Shanghai Pulmonary HospitalRecruiting
- Liaoning Cancer Hospital& InstituteRecruiting
- The First Hospital of China Medical UniversityRecruiting
- Union Hospital Affiliated With Tongji Medical College Huazhong University of Science and TechnologyRecruiting
- Hubei Cancer HospitalRecruiting
- The First Affiliate Hospitalof Xi'An Jiaotong UniversityRecruiting
- The First Affiliated Hospital Xiamen UniversityRecruiting
- Xinjiang Tumor HospitalRecruiting
- Bordeaux University Hospital - Hopital Saint AndreRecruiting
- Institut BergonieRecruiting
- Centre Hospitalier Universitaire de LilleRecruiting
- Centre Leon BerardRecruiting
- APHM - Hopital NordRecruiting
- Centre Hospitalier Universitaire de MontpellierRecruiting
- Hopital prive du ConfluentRecruiting
- CHU de NantesRecruiting
- AP-HP - Hopital TenonRecruiting
- CHU de Poitier Pole Regional de CancerologieRecruiting
- Hopital FOCHRecruiting
- Evangelische Lungenklinik BerlinRecruiting
- Klinikum Esslingen GmbHRecruiting
- LungenClinic GrosshansdorfRecruiting
- Klinikum der Universitaet MuenchenRecruiting
- Metropolitan HospitalRecruiting
- Sotiria General Hosptial of Chest DiseasesRecruiting
- University Hospital of Ioannina UhiRecruiting
- Metropolitan HospitalRecruiting
- Bioclinic ThessalonikiRecruiting
- Prince of Wales Hospital / The Chinese University of Hong Kong 99999Recruiting
- Queen Elizabeth HospitalRecruiting
- Queen Mary HospitalRecruiting
- Semmelweis University Department of PulmonologyRecruiting
- Veszprem Megyei Tudogyogyintezet FarkasgyepuRecruiting
- Bkmk HospitalRecruiting
- Fejer Megyei Szent Gyorgy Egyetemi Oktato KorhazRecruiting
- Pulmonology Hospital TorokbalintRecruiting
- IRCCS Istituto Oncologico Giovanni Paolo IIRecruiting
- UOC OncologiaRecruiting
- IRCCS Ospedale San RaffaeleRecruiting
- Irccs Istituto Europeo Di OncologiaRecruiting
- Azienda Ospedaliera dei ColliRecruiting
- A.O. Perugia Santa Maria della MisericordiaRecruiting
- Policlinico Tor VergataRecruiting
- Ifo Regina ElenaRecruiting
- Asst Sette Laghi Ospedale di Circolo e Fondazione MacchiRecruiting
- Aomori Prefectural Central HospitalRecruiting
- National Cancer Center Hospital EastRecruiting
- NHO Shikoku Cancer CenterRecruiting
- National Hospital Organization Kyushu Cancer CenterRecruiting
- Kyushu University HospitalRecruiting
- Kurume University HospitalRecruiting
- Kanazawa University HospitalRecruiting
- Kanagawa Cancer CenterRecruiting
- Saiseikai Kumamoto HospitalRecruiting
- Matsusaka Municipal HospitalRecruiting
- Sendai Kousei HospitalRecruiting
- Niigata Cancer Center HospitalRecruiting
- Kansai Medical University HospitalRecruiting
- Osaka International Cancer InstituteRecruiting
- NHO Kinki-Chuo Chest Medical CenterRecruiting
- Saitama Cancer CenterRecruiting
- Dokkyo Medical University HospitalRecruiting
- Juntendo University HospitalRecruiting
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalRecruiting
- The Cancer Institute Hospital of JFCRRecruiting
- Toho University Omori Medical CenterRecruiting
- NHO Iwakuni Clinical CenterRecruiting
- Yamaguchi-Ube Medical CenterRecruiting
- Teine Keijinkai HospitalRecruiting
- Chungbuk National University HospitalRecruiting
- Seoul National University Bundang HospitalRecruiting
- Kyungpook National University Chilgok HospitalRecruiting
- National Cancer CenterRecruiting
- Samsung Medical CenterRecruiting
- The Catholic Univ. of Korea, Seoul St. Mary'S HospitalRecruiting
- Asan Medical CenterRecruiting
- Cryptex Investigacion Clinica Sa de CvRecruiting
- Hospital Civil de Guadalajara Fray Antonio AlcaldeRecruiting
- Hospital Universitario Dr. Jose Eleuterio GonzalezRecruiting
- Centro de Investigacion Clinica de Oaxaca (CICLO)Recruiting
- Oncologico PotosinoRecruiting
- Rijnstate ZiekenhuisRecruiting
- Amsterdam Umc, Location VumcRecruiting
- Leiden University Medical CenterRecruiting
- Jeroen Bosch Ziekenhuis J BZ Hieronymus Bosch HospitalRecruiting
- Instytut Centrum Zdrowia Matki PolkiRecruiting
- Dom Lekarski SARecruiting
- II Klinika Chorob Pluc I GruzlicyRecruiting
- Centro Clinico ChampalimauRecruiting
- Centro Hospitalar e Universitário do PortoRecruiting
- Hospital CUF PortoRecruiting
- Onco Clinic Consult SARecruiting
- Sc Sigmedical Services SrlRecruiting
- Oncocenter-Oncologie Clinica SRLRecruiting
- SC Oncomed SRLRecruiting
- Hospital Clinic i Provincial de BarcelonaRecruiting
- Hospital Universitari Vall D'HebronRecruiting
- Hospital Universitario Arnau de Vilanova - LleidaRecruiting
- Hospital General Universitario Gregorio MarañonRecruiting
- Hospital Clinico San CarlosRecruiting
- Hospital Universitario Fundacion Jimenez DiazRecruiting
- Hospital Regional Universitario MalagaRecruiting
- CHUORecruiting
- Hospital Universitario Virgen MacarenaRecruiting
- Hospital Universitari i Politècnic La FeRecruiting
- Hospital Universitario Miguel ServetRecruiting
- Kantonsspital BadenRecruiting
- University Hospital BaselRecruiting
- Kantonsspital BasellandRecruiting
- E-Da HospitalRecruiting
- Chang Gung Memorial Hospital Cgmh - Kaohsiung BranchRecruiting
- Chung Shan Medical University HospitalRecruiting
- Taichung Veterans General HospitalRecruiting
- National Cheng Kung University Hospital NckuhRecruiting
- Taipei Veterans General HospitalRecruiting
- National Taiwan University HospitalRecruiting
- Koo Foundation Sun Yat-Sen Cancer CenterRecruiting
- Chang Gung Memorial Hospital LinKouRecruiting
- Srinagarind HospitalRecruiting
- Prince of Songkla University PSU - Faculty of MedicineRecruiting
- Faculty of Medicine Chulalongkorn UniversityRecruiting
- Siriraj HospitalRecruiting
- Birmingham Heartlands HospitalRecruiting
- Beatson West of Scotland Cancer CentreRecruiting
- Nottingham University HospitalsRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Pembrolizumab + Datopotamab Deruxtecan (Dato-DXd)
Pembrolizumb
Participants will be randomized to receive 200 mg pembrolizumab followed by 6.0mg/kg Dato-DXd.
Participants will be randomized to receive 200 mg pembrolizumab.