Phase III, Open-label, Study of First-line Dato-DXd in Combination With Rilvegostomig for Advanced Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations
Recruiting now Phase 3 NCT06357533
Run by AstraZeneca · for 18 and older · All sexes
What this study is about
The purpose of this study is to evaluate efficacy and safety of Dato-DXd in combination with rilvegostomig or rilvegostomig monotherapy compared with pembrolizumab monotherapy as a first line therapy in participants with locally advanced or metastatic non-squamous NSCLC with high PD-L1 expression (TC ≥ 50%) and without actionable genomic alterations.
Who can join (things the study team will check)
✅ You may be able to join if…
- Histologically or cytologically documented non-squamous NSCLC.
- Stage IIIB or IIIC or Stage IV metastatic NSCLC (according to Edition 8 of the AJCC staging manual) not amenable to curative surgery or definitive chemoradiation.
- Absence of sensitising EGFR mutations, and ALK and ROS1 rearrangements, and absence of documented local test result for any other known genomic alteration for which there are locally approved and available targeted first-line therapies.
- Must provide tumor sample to determine PD-L1 status, TROP2 status and other biomarkers.
- Known tumour PD-L1 expression status defined as TC ≥ 50%
- At least one lesion, not previously irradiated that qualifies as a RECIST 1.1 target lesion at baseline
- ECOG performance status of 0 or 1
- Adequate bone marrow reserve and organ function
🚫 You may not be able to join if…
- Prior systemic therapy for advanced/metastatic NSCLC.
- Squamous cell histology, or predominantly squamous cell histology NSCLC; mixed small cell lung cancer; NSCLC histology, sarcomatoid variant.
- History of another primary malignancy within 3 years
- Active or prior documented autoimmune or inflammatory disorders (with exceptions)
- Any evidence of severe or uncontrolled disease that makes it undesirable for the participant to participate in the study or that would jeopardies compliance with the protocol.
- Has clinically significant third-space fluid retention (for example pleural effusion) and is not amenable for repeated drainage.
- History of any ILD/pneumonitis, including radiation pneumonitis (apart from radiation pneumonitis that did not require steroids), or drug-induced ILD/pneumonitis, has current or suspected ILD/pneumonitis that cannot be ruled out by imaging at screening.
- Has significant pulmonary function compromise, as determined by the investigator
- Spinal cord compression, or brain metastases unless participant treated and no longer symptomatic, radiologically stable, and who require no treatment with corticosteroids or anticonvulsants.
- History of leptomeningeal carcinomatosis
- Known clinically significant corneal disease
- Active infection with TB, HBV, HCV, Hepatitis A, or known HIV infection that is not well controlled
- History of active primary immunodeficiency
Where this trial is running
- Research Site, Anchorage, Alaska, United States
- Research Site, Tucson, Arizona, United States
- Research Site, Little Rock, Arkansas, United States
- Research Site, Springdale, Arkansas, United States
- Research Site, Anaheim, California, United States
- Research Site, Beverly Hills, California, United States
- Research Site, Fountain Valley, California, United States
- Research Site, Newport Beach, California, United States
- Research Site, Clermont, Florida, United States
- Research Site, Gainesville, Florida, United States
- Research Site, Miami Beach, Florida, United States
- Research Site, Orange City, Florida, United States
+ 271 more sites.
Who to contact
AstraZeneca Clinical Study Information Center · 1-877-240-9479 · information.center@astrazeneca.com
It's completely normal to call and ask questions before deciding anything. Mention the study ID: NCT06357533.
Verify everything on the official ClinicalTrials.gov record. Page updated July 2026.
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