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RecruitingInterventionalPhase 3

A Phase III, Open-label, Randomised Study of Datopotamab Deruxtecan (Dato-DXd) With or Without Durvalumab Compared With Investigator's Choice of Chemotherapy (Paclitaxel, Nab-paclitaxel or Gemcitabine + Carboplatin) in Combination With Pembrolizumab in Patients With PD-L1 Positive Locally Recurrent Inoperable or Metastatic Triple-negative Breast Cancer (TROPION-Breast05)

NCT ID: NCT06103864Sponsor: AstraZenecaLast updated: 2026-04-30

Summary

This is a Phase III, randomised, open-label, 3-arm, multicentre, international study assessing the efficacy and safety of Dato-DXd with or without durvalumab compared with investigator's choice chemotherapy in combination with pembrolizumab in participants with PD-L1 positive locally recurrent inoperable or metastatic TNBC.

Detailed description

The primary objective of the study is to demonstrate superiority of Dato-DXd + durvalumab relative to ICC + pembrolizumab by assessment of PFS as assessed by BICR in participants with PD-L1 positive locally recurrent inoperable or metastatic TNBC. The study will be stratified based on geographic location (US/Canada/Europe vs. Dato-DXd monotherapy enrolling countries vs. rest of world), disease-free interval (DFI) history (de novo vs. prior DFI 6 to 12 months vs. prior DFI \> 12 months), and prior PD-1/PD-L1 treatment for early stage TNBC (yes vs. no). This study aims to see if Dato-DXd with durvalumab allows patients to live longer without their breast cancer getting worse, or simply to live longer, compared to patients receiving standard of care chemotherapy and pembrolizumab. This study is also looking to see how the treatment and the breast cancer affects patients' quality of life.

Arms & interventions

  • DrugDato-DXd

    Provided in 100mg vials. IV infusion. Experimental drug.

  • DrugDurvalumab

    Provided in 500mg vials. IV infusion. Experimental drug.

  • DrugPaclitaxel

    IV infusion. Active comparator.

  • DrugNab-paclitaxel

    IV infusion. Active comparator.

  • DrugGemcitabine

    IV infusion. Active comparator.

  • DrugCarboplatin

    IV infusion. Active comparator.

  • DrugPembrolizumab

    IV infusion. Active comparator.

Outcome measures

Primary

  • Progression Free Survival (PFS)

    PFS is defined as time from randomisation until progression per RECIST 1.1 as assessed by BICR, or death due to any cause. The comparison will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy, receives another anticancer therapy or clinically progresses prior to RECIST 1.1 progression. However, if the participant progresses or dies immediately after 2 or more consecutive missed visits, the participant will be censored at the time of the latest evaluable assessment prior to the 2 missed visits. The measure of interest is the HR of PFS.

    Time frame: From randomisation until progression per RECIST 1.1 as assessed by BICR, or death due to any cause (anticipated to be up to 33 months).

Secondary

  • Overall Survival (OS)

    Time frame: From randomisation until the date of death due to any cause (anticipated to be up to 64 months).

  • Objective Response Rate (ORR)

    Time frame: From randomisation up until progression (anticipated to be up to 33 months).

  • Duration of Response (DoR)

    Time frame: From the date of first documented response until date of documented progression per RECIST 1.1, as assessed by BICR/investigator assessment or death due to any cause (anticipated to be up to 33 months).

  • Progression-Free Survival (PFS) by Investigator assessment

    Time frame: From randomisation until progression per RECIST 1.1 as assessed by the investigator, or death due to any cause (anticipated to be up to 33 months).

  • Clinical Benefit Rate (CBR) at 24 weeks

    Time frame: From randomisation up until progression, or the last evaluable assessment in the absence of progression (anticipated to be up to 33 months).

  • Time to deterioration (TTD) in breast and arm symptoms in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab

    Time frame: From the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).

  • Time to deterioration (TTD) in pain in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab

    Time frame: Time from the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).

  • Time to deterioration (TTD) in physical functioning in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab

    Time frame: From the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).

  • Time to deterioration (TTD) in GHS/QoL in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab

    Time frame: From the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).

  • Time to First Subsequent Therapy (TFST)

    Time frame: From randomisation until the start date of the first subsequent anticancer therapy after discontinuation of randomised treatment, or death due to any cause (anticipated to be up to 64 months).

  • Time to Second Subsequent Therapy (TSST)

    Time frame: From randomisation until the start date of the second subsequent anti cancer therapy after discontinuation of first subsequent treatment, or death due to any cause (anticipated to be up to 64 months).

  • Progression Free Survival 2 (PFS2)

    Time frame: From the randomisation to the earliest of the progression event (following the initial progression), subsequent to first subsequent therapy, or death (anticipated to be up to 64 months).

  • Pharmacokinetics of Dato-DXd in combination with durvalumab

    Time frame: From first dose to end of treatment (anticipated to be up to 33 months).

  • Immunogenicity of Dato-DXd in combination with durvalumab

    Time frame: From first dose to end of treatment safety follow-up (anticipated to be up to 33 months).

  • Safety and tolerability of Dato-DXd + durvalumab as compared with ICC + pembrolizumab

    Time frame: From first dose to end of treatment safety follow-up (anticipated to be up to 33 months).

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Key Inclusion Criteria * Histologically or cytologically documented locally recurrent inoperable, which cannot be treated with curative intent, or metastatic TNBC, as defined by the ASCO-CAP guidelines. * ECOG PS 0 or 1. * Participants are expected to provide an FFPE tumour sample collected from a locally recurrent inoperable or metastatic tumour. Alternatively, an archival FFPE tumour sample can be submitted; it must have been collected ≤ 3 years prior to the participant signing informed consent (screening start). * PD-L1 positive TNBC based on results from an appropriately validated investigational PD-L1 (22C3) assay (CPS ≥ 10) from a sponsor designated central laboratory. * No prior chemotherapy or other systemic anti-cancer therapy for metastatic or locally recurrent inoperable breast cancer. \- Patients with recurrent disease will be eligible if they have completed treatment for Stage I-III breast cancer, if indicated, and ≥6 months have elapsed between completion of treatment with curative intent and the first documented recurrence. * Eligible for one of the chemotherapy options listed as ICC (paclitaxel, nab-paclitaxel, or gemcitabine + carboplatin). * Measurable disease as per RECIST 1.1. * Adequate bone marrow reserve and organ function. * Male and female participants of childbearing potential must agree to use protocol-specified method(s) of contraception. Key Exclusion Criteria * As judged by investigator, any evidence of diseases (such as severe or uncontrolled medical conditions including systemic diseases, uncontrolled hypertension, serious gastrointestinal conditions associated with diarrhoea, chronic diverticulitis or previous complicated diverticulitis, history of allogeneic organ transplant, and active bleeding diseases, ongoing and active infection, significant cardiac conditions, substance abuse, psychiatric illness/social situation or psychological conditions) which, in the investigator's opinion, makes it undesirable for the participant to participate in the study or that would jeopardize compliance with the protocol. * History of another primary malignancy except for malignancy treated with curative intent with no known active disease within 2 years before Cycle 1 Day 1 and of low potential risk for recurrence. * Participants with a history of previously treated neoplastic spinal cord compression or treated, clinically inactive brain metastases that are no longer symptomatic, who require no treatment with corticosteroids or anticonvulsants, may be included in the study if they have recovered from acute toxic effects of radiotherapy. \- Participants with treated clinically inactive brain metastases that are no longer symptomatic, who require no treatment with corticosteroids or anticonvulsants, may be included in the study if they have recovered from acute toxic effects of radiotherapy. * Uncontrolled infection requiring IV antibiotics, antivirals or antifungals. * Active or uncontrolled hepatitis B or C virus infection. * Known HIV infection that is not well controlled. * Uncontrolled or significant cardiac disease. * History of non-infectious ILD/pneumonitis (including radiation pneumonitis) that required steroids, current ILD/pneumonitis, or suspected ILD/pneumonitis that cannot be ruled out by imaging at screening. * Clinically severe pulmonary function compromise. * Clinically significant corneal disease. * Active or prior documented autoimmune or inflammatory disorders. * Prior exposure to any treatment including ADC containing a chemotherapeutic agent targeting topoisomerase I and TROP2-targeted therapy. * Any concurrent anti-cancer treatment. * Participants with a known severe hypersensitivity to PD-1/PD-L1 inhibitors or Dato-DXd. * Currently pregnant (confirmed with positive pregnancy test), breastfeeding or planning to become pregnant.

Study locations (64)

Research Site

Daphne, Alabama, 36526

Recruiting

Research Site

Springdale, Arkansas, 72762

Recruiting

Research Site

Duarte, California, 91010

Withdrawn

Research Site

Glendale, California, 91204

Recruiting

Research Site

Sacramento, California, 95817

Recruiting

Research Site

Santa Rosa, California, 95403

Withdrawn

Research Site

Aurora, Colorado, 80012

Recruiting

Research Site

New Haven, Connecticut, 06510

Recruiting

Research Site

Jacksonville, Florida, 32256

Withdrawn

Research Site

Miami, Florida, 33176

Recruiting

Research Site

Palm Bay, Florida, 32909

Withdrawn

Research Site

Plantation, Florida, 33324

Recruiting

Research Site

Atlanta, Georgia, 30318

Suspended

Research Site

Honolulu, Hawaii, 96819

Withdrawn

Research Site

Chicago, Illinois, 60637

Recruiting

Research Site

Decatur, Illinois, 62526

Withdrawn

Research Site

Elmhurst, Illinois, 60126

Withdrawn

Research Site

Naperville, Illinois, 60540

Withdrawn

Research Site

New Albany, Indiana, 47150

Withdrawn

Research Site

Des Moines, Iowa, 50309

Recruiting

Research Site

Lexington, Kentucky, 40503

Withdrawn

Research Site

Louisville, Kentucky, 40202

Withdrawn

Research Site

Louisville, Kentucky, 40207

Withdrawn

Research Site

Baton Rouge, Louisiana, 70808

Withdrawn

Research Site

Baton Rouge, Louisiana, 70809

Recruiting

Research Site

Baltimore, Maryland, 21215

Withdrawn

Research Site

Columbia, Maryland, 21044

Recruiting

Research Site

Boston, Massachusetts, 02111

Withdrawn

Research Site

Worcester, Massachusetts, 01655

Withdrawn

Research Site

Detroit, Michigan, 48201

Recruiting

Research Site

Grand Rapids, Michigan, 49503

Withdrawn

Research Site

Saint Paul, Minnesota, 55109

Recruiting

Research Site

Hattiesburg, Mississippi, 39401

Withdrawn

Research Site

St Louis, Missouri, 63129

Recruiting

Research Site

Albuquerque, New Mexico, 87109

Recruiting

Research Site

Albany, New York, 12206

Withdrawn

Research Site

New York, New York, 10065

Recruiting

Research Site

Stony Brook, New York, 11794-7263

Recruiting

Research Site

Cincinnati, Ohio, 45219

Recruiting

Research Site

Cincinnati, Ohio, 45245

Recruiting

Research Site

Cleveland, Ohio, 44195

Recruiting

Research Site

York, Pennsylvania, 17403

Withdrawn

Research Site

Providence, Rhode Island, 02903

Recruiting

Research Site

Chattanooga, Tennessee, 37404

Recruiting

Research Site

Nashville, Tennessee, 37203

Recruiting

Research Site

Dallas, Texas, 75230

Withdrawn

Research Site

Dallas, Texas, 75246

Recruiting

Research Site

Dallas, Texas, 75246

Withdrawn

Research Site

El Paso, Texas, 79902

Recruiting

Research Site

Flower Mound, Texas, 75028

Withdrawn

Research Site

Fort Worth, Texas, 76104

Withdrawn

Research Site

Houston, Texas, 77054

Withdrawn

Research Site

Houston, Texas, 77090

Withdrawn

Research Site

Houston, Texas, 77098

Withdrawn

Research Site

Kingwood, Texas, 77339

Withdrawn

Research Site

McKinney, Texas, 75071

Withdrawn

Research Site

Sugar Land, Texas, 77479

Recruiting

Research Site

Charlottesville, Virginia, 22903

Recruiting

Research Site

Fairfax, Virginia, 22031

Recruiting

Research Site

Midlothian, Virginia, 23114

Recruiting

Research Site

Norfolk, Virginia, 23502

Recruiting

Research Site

Roanoke, Virginia, 24014

Recruiting

Research Site

Tacoma, Washington, 98405

Recruiting

Research Site

Madison, Wisconsin, 53792

Withdrawn

References

  • Schmid P, Oliveira M, O'Shaughnessy J, Cristofanilli M, Graff SL, Im SA, Loi S, Saji S, Wang S, Cescon DW, Hovey T, Nawrot A, Tse K, Vukovic P, Curigliano G. TROPION-Breast05: a randomized phase III study of Dato-DXd with or without durvalumab versus chemotherapy plus pembrolizumab in patients with PD-L1-high locally recurrent inoperable or metastatic triple-negative breast cancer. Ther Adv Med Oncol. 2025 Apr 17;17:17588359251327992. doi: 10.1177/17588359251327992. eCollection 2025.(PubMed)