TROPION-Lung04: Dato-DXd Plus Immunotherapy in Advanced NSCLC

This is a synopsis of a Peer Exchange video series featuring Benjamin P. Levy, MD, of Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Solange Peters, MD, PhD, of University Hospital of Lausanne; Joshua K. Sabari, MD, of NYU Langone’s Perlmutter Cancer Center; Edward B. Garon, MD, MS, of UCLA Jonsson Comprehensive Cancer Center; and Marina Chiara Garassino, MD, of University of Chicago Medicine Comprehensive Cancer Center.

Dr Levy asks Dr Sabari to summarize results from the phase 1b TROPION-Lung04 study adding the ADC [antibody-drug conjugate] datopotamab deruxtecan to durvalumab with or without platinum chemotherapy in the first-line setting. Dr Sabari states the early data shows the combinations appear relatively safe and tolerable, though larger studies are needed before changing practice.

Dr Peters notes it remains unclear whether platinum chemotherapy adds benefit over the ADC-immunotherapy combination, with conflicting early data from different trials. She cautions about the risk of interstitial lung disease (ILD) with ADCs plus immunotherapy in the curative-intent frontline setting. Dr Levy agrees, stating his risk tolerance for ILD would be lower in PD-L1 high versus low/negative patients if it meant stopping pembrolizumab. In conclusion, the experts concur more data is needed to determine if ADCs plus immunotherapy can replace current platinum-based chemotherapy regimens in particular NSCLC patient subgroups.

*Video synopsis is AI-generated and reviewed by OncLive editorial staff.