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RecruitingInterventionalPhase 3

A Phase III, Open-label, Sponsor-blind, Randomized Study of Dato-DXd With or Without Osimertinib Versus Platinum-based Doublet Chemotherapy for Participants With EGFR-mutated Locally Advanced or Metastatic Non-small Cell Lung Cancer Whose Disease Has Progressed on Prior Osimertinib Treatment (TROPION-Lung15)

NCT ID: NCT06417814Sponsor: AstraZenecaLast updated: 2026-05-14

Summary

This study will assess the effect of Dato-DXd in combination with osimertinib or Dato-DXd monotherapy versus platinum-based doublet chemotherapy in terms of progression-free survival (PFS).

Detailed description

This is a Phase III, open-label, 3-arm, multicenter study assessing the effects of Dato-DXd in combination with osimertinib or Dato-DXd monotherapy versus platinum-based doublet chemotherapy in participants with epidermal growth factor receptor gene mutation (EGFRm) locally advanced or metastatic non-small cell lung cancer (NSCLC) whose disease has progressed on prior osimertinib treatment. Participants will be randomized in a 1:1:1 ratio to one of the following intervention groups: 1. Dato-DXd + osimertinib combination therapy 2. Dato-DXd monotherapy 3. Platinum-based doublet chemotherapy Participants will receive study intervention until Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1) -defined radiological progression by the investigator, unacceptable toxicity, or other discontinuation criterion is met. After study intervention discontinuation, all participants will undergo an end of treatment (EoT) visit within 35 days of discontinuation and will be followed up for safety assessments 28 (+ 7) days after their last dose of study intervention.

Arms & interventions

  • DrugDato-DXd

    Dato-DXd will be administered as IV infusion.

  • DrugOsimertinib

    Osimertinib will be administered orally.

  • DrugPemetrexed

    Pemetrexed will be administered as IV infusion.

  • DrugCarboplatin

    Carboplatin will be administered as IV infusion.

  • DrugCisplatin

    Cisplatin will be administered as IV infusion.

Outcome measures

Primary

  • Progression free Survival (PFS)

    PFS is defined as the time from randomization to Blinded Independent Central Review (BICR)-assessed progression using RECIST v1.1 or death due to any cause, regardless of whether the participant withdraws from study therapy, receives other anti-cancer therapy, or clinical progression.

    Time frame: Up to 2.5 years

Secondary

  • Overall Survival (OS)

    Time frame: Up to 3.5 years

  • Central Nervous System Progression-free Survival (CNS PFS)

    Time frame: Up to 2.5 years

  • Objective Response Rate (ORR)

    Time frame: Up to 2.5 years

  • Duration of Response (DoR)

    Time frame: Up to 2.5 years

  • Progression-free Survival-2 (PFS-2)

    Time frame: Up to 3.5 years

  • Objective Response Rate (ORR) Using CNS Modified RECIST v1.1

    Time frame: Up to 2.5 years

  • Duration of Response (DoR) Using CNS Modified RECIST v1.1

    Time frame: Up to 2.5 years

  • Time to Deterioration in Pulmonary Symptoms

    Time frame: Up to 3.5 years

  • Time to Deterioration in Physical Functioning

    Time frame: Up to 3.5 years

  • Time to Deterioration in Global Health Status (GHS)/Quality of Life (QoL)

    Time frame: Up to 3.5 years

  • Pharmacokinetics (PK) of Dato-DXd

    Time frame: Up to 3.5 years

  • Immunogenicity of Dato-DXd

    Time frame: Up to 3.5 years

Eligibility criteria

Sex: AllAge: 18 Years to 130 YearsHealthy volunteers: No
Inclusion Criteria: * Histologically or cytologically confirmed non-squamous NSCLC. * Must have evidence of documented pre-existing EGFRm information (EGFRm known to be associated with (epidermal growth factor receptor \[EGFR\] tyrosine kinase inhibitor \[TKis\] sensitivity \[Ex19del, L858R, G719X, S768I, or L861Q\], either alone or in combination with other EGFR mutations, which may include T790M). * Documented extra-cranial radiologic progression on prior osimertinib monotherapy (as most recent line of treatment) in the adjuvant, locally advanced, or metastatic setting. * Less than or equal to (\<=2) prior lines of EGFR TKIs (osimertinib is the only permitted prior third generation EGFR TKI). * At least one lesion, not previously irradiated, that qualifies as a RECIST v1.1 TL at baseline and can be accurately measured at baseline. * World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. * Adequate bone marrow reserve and organ function within 7 days before randomization. Exclusion Criteria: * Use of chemotherapy, vascular endothelial growth factor inhibitor, immunotherapy or any anti-cancer therapy in the metastatic setting. Platinum-based chemotherapy in non-metastatic setting within 12 months prior to randomization. * History of another primary malignancy except for malignancy treated with curative intent with no known active disease within 2 years before the first dose of study intervention. * Any evidence of severe or uncontrolled systemic diseases, including, but not limited to active bleeding diseases, active infection, active ILD/pneumonitis, cardiac disease. * Has significant third-space fluid retention (example \[eg.\], ascites or pleural effusion) as judged by the investigator and is not amenable for required repeated drainage. * History of non-infectious ILD/pneumonitis including radiation pneumonitis that required steroids or drug-induced ILD, has current ILD/pneumonitis, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at screening. * Has severe pulmonary function compromise resulting from intercurrent pulmonary illnesses. * Unstable spinal cord compression and/or unstable brain metastases. * Participants with symptomatic brain metastases (including leptomeningeal involvement). * Clinically significant corneal disease. * Uncontrolled infection requiring systemic antibiotics, antivirals, or antifungals, suspected infections or inability to rule out infections. Use of systemic antibiotics within 14 days of randomization. * Has known human immunodeficiency virus (HIV) infection that is not well controlled.

Study locations (34)

Research Site

Fayetteville, Arkansas, 72703

Recruiting

Research Site

Duarte, California, 91010

Withdrawn

Research Site

Fountain Valley, California, 92708

Recruiting

Research Site

La Jolla, California, 92093

Recruiting

Research Site

Los Angeles, California, 90048

Withdrawn

Research Site

San Diego, California, 92123

Recruiting

Research Site

Colorado Springs, Colorado, 80909

Recruiting

Research Site

Fort Collins, Colorado, 80528

Recruiting

Research Site

Washington D.C., District of Columbia, 20007

Not Yet Recruiting

Research Site

Gainesville, Florida, 32608

Withdrawn

Research Site

Jacksonville, Florida, 32256

Recruiting

Research Site

Athens, Georgia, 30607

Recruiting

Research Site

Chicago, Illinois, 60611

Recruiting

Research Site

Evanston, Illinois, 60201

Recruiting

Research Site

Louisville, Kentucky, 40207

Recruiting

Research Site

Baltimore, Maryland, 21201

Recruiting

Research Site

Bethesda, Maryland, 20817

Recruiting

Research Site

Boston, Massachusetts, 02114

Withdrawn

Research Site

Boston, Massachusetts, 02215

Recruiting

Research Site

Detroit, Michigan, 48202

Recruiting

Research Site

Kansas City, Missouri, 64132

Recruiting

Research Site

Omaha, Nebraska, 68124

Recruiting

Research Site

Morristown, New Jersey, 07960

Recruiting

Research Site

Northfield, New Jersey, 08225

Recruiting

Research Site

New York, New York, 10016

Withdrawn

Research Site

New York, New York, 10065

Recruiting

Research Site

The Bronx, New York, 10461

Recruiting

Research Site

Maumee, Ohio, 43537

Recruiting

Research Site

Philadelphia, Pennsylvania, 19107

Withdrawn

Research Site

Pittsburgh, Pennsylvania, 15232

Recruiting

Research Site

Chattanooga, Tennessee, 37404

Recruiting

Research Site

Nashville, Tennessee, 37203

Recruiting

Research Site

Fairfax, Virginia, 22031

Recruiting

Research Site

Seattle, Washington, 98104

Withdrawn

References

  • Tan DS, Nadal E, Cheema P, Wu YL, Ahn MJ, Tanizaki J, Grainger E, Nizialek E, Forcina A, van der Gronde T, Yu HA. TROPION-Lung15: a randomized phase III study of osimertinib combined with datopotamab deruxtecan (Dato-DXd) or Dato-DXd alone versus platinum-doublet chemotherapy in patients with EGFR-mutated advanced non-small cell lung cancer and whose disease has progressed on prior osimertinib. Ther Adv Med Oncol. 2025 Dec 23;17:17588359251385410. doi: 10.1177/17588359251385410. eCollection 2025.(PubMed)