A Study to Evaluate the Benefit of Adding Durvalumab After Chemotherapy, Durvalumab and Surgery in Patients With Early-stage, Operable, Non-small Cell Lung Cancer.

NCT ID: NCT06284317

Last Updated: 2025-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

290 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-15

Study Completion Date

2030-03-31

Brief Summary

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ADOPT-lung is an international, multicentre, open-label randomised phase III trial. Protocol treatment consists of 3-4 cycles of neoadjuvant durvalumab in combination with platinum-based doublet chemotherapy, followed by surgery. Patients with R0 and R1 only resection will be randomised to receive either adjuvant durvalumab for 12 cycles (experimental arm) or observation (control arm). The primary objective of the study is to determine whether additional adjuvant immunotherapy with durvalumab after neoadjuvant chemo-immunotherapy has an effect on disease-free survival (DFS) in patients who do not achieve complete pathological response (pCR) as per local assessment according to the IASLC recommendations.

Detailed Description

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Conditions

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Non Small Cell Lung Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Durvalumab

Protocol treatment in the adjuvant phase consists of adjuvant durvalumab

Group Type EXPERIMENTAL

Adjuvant durvalumab

Intervention Type DRUG

Durvalumab is given at a fixed dose of 1500 mg i.v. every 4 weeks (±1 week) until relapse or unacceptable toxicity, for a maximum of 12 cycles after surgery.

Observation

Observation only

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Adjuvant durvalumab

Durvalumab is given at a fixed dose of 1500 mg i.v. every 4 weeks (±1 week) until relapse or unacceptable toxicity, for a maximum of 12 cycles after surgery.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed NSCLC.
* Stage IIB-IIIB (T1-4 N0-2) according to 8th edition of the TNM staging system of lung cancer.

Stage III assessment should include samples of lymph nodes at levels 4, bilaterally, and level 7 to rule out stage IIIB N3 disease.

T4 tumours will only be eligible if they are defined as T4 based only on their size (\>7cm); any other reason will be considered ineligible.

* Known PD-L1 status, as tested locally using a validated assay. To ensure comparability of results, it is strongly encouraged that PD-L1 testing is done with the Ventana PD-L1 (SP263) assay.
* Absence of EGFR mutation or ALK translocation, as tested locally.
* Primary tumour resectable and functionally operable as assessed per local multidisciplinary tumour board (cardiac evaluation, pulmonary function and diffusion capacity, comorbidity).
* Adequate haematological function:

Haemoglobin ≥90 g/L, Absolute neutrophil count (ANC) ≥1.0× 109/L, Platelet count ≥75× 109/L.

\- Adequate renal function: Measured creatinine clearance (CL) \>40 mL/min or calculated CL \>40 mL/min calculated by the Cockcroft-Gault.

\- Adequate liver function: ALT and AST ≤2.5× institutional ULN, Total serum bilirubin ≤1.5× institutional ULN (patients with Gilbert's syndrome may be allowed to be enrolled after consultation with the Medical Affairs Team at the ETOP IBCSG Partners Foundation.

* Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
* Age ≥18 at the time of enrolment.
* Body weight \>30 kg.
* Life expectancy of at least 12 weeks.
* Women of childbearing potential, including women who had their last menstruation in the last 2 years, must have a negative urinary or serum pregnancy test at screening before enrolment. Pregnancy test must be repeated within 3 days before the first dose of protocol treatment.
* Written IC for study participation must be signed and dated by the patient and the investigator prior to any study-related intervention.

Eligibility Criteria for randomisation:

* Surgical resection must have been completed. Note: Participants who have had only had segmentectomy or wedge resections are not eligible for randomisation.
* Patients must have complete resection: R0 or R1 resection.
* Patients must be fit to receive adjuvant treatment with durvalumab.
* Patients must have no evidence of metastatic disease as assessed by CT scan.
* Documentation of pathological response as per local review must be available.

Exclusion Criteria

* T4 with invasion of heart, great vessels, carina, trachea, oesophagus, or spine.
* Any previous or concurrent treatments for NSCLC.
* Any previous immunotherapy.
* Major surgical procedure (as per investigators assessment) within 28 days before enrolment.
* History of allogenic organ transplantation.
* Active or prior documented autoimmune disease or inflammatory disorders (including inflammatory bowel disease \[e.g., colitis or Crohn's disease\], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome \[granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc.\]). The following are exceptions to this criterion:

Patients with vitiligo or alopecia. Patients with type I diabetes. Patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement.

Any chronic skin condition that does not require systemic therapy. Patients without active disease in the last 5 years may be included but only after consultation with the Medical Affairs Team at the ETOP IBCSG Partners Foundation.

Patients with celiac disease controlled by diet alone.

* Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease (ILD), or serious chronic gastrointestinal conditions associated with diarrhoea.
* Psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent.
* History of another primary malignancy except for:

Malignancy treated with curative-intent and with no known active disease 5 years before the first dose of durvalumab 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.

* History of leptomeningeal carcinomatosis.
* History of active primary immunodeficiency.
* Active hepatitis infection, positive hepatitis C virus (HCV) antibody, hepatitis B virus (HBV) surface antigen (HbsAg) or HBV core antibody (anti-HBc).

Participants with a past or resolved HBV infection (defined as the presence of anti-HBc and absence of HbsAg) are eligible.

Participants positive for HCV antibody are only eligible if polymerase chain reaction is negative for HCV RNA.

* Known HIV infection that is not well-controlled. All of the following criteria are required to define an HIV infection that is well controlled: undetectable viral RNA load for 3 months, CD4+ count of 500 cell per mm3, no history of AIDS-defining opportunistic infection within the past 12 months, and stable for at least 3 months on the same anti-HIV medication.
* Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab. The following are exceptions to this criterion:

Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection).

Systemic corticosteroids at physiologic doses not exceeding 10 mg/day of prednisone or its equivalent.

Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication).

\- Receipt of live attenuated vaccine within 30 days prior to the first dose of durvalumab.

Note: Patients in the ADOPT-lung trial, should not receive live vaccine whilst receiving durvalumab and for up to 30 days after the last dose.

Concurrent enrolment in another interventional clinical trial.

* Known allergy or suspected hypersensitivity to durvalumab or its excipients.
* Judgment by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions, and requirements.
* Female patients who are pregnant or in the period of lactation.
* Female patients of childbearing potential and sexually active men who are not willing to use a highly effective contraceptive method during the trial until at least 90 days after the last dose of protocol treatment.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AstraZeneca

INDUSTRY

Sponsor Role collaborator

ETOP IBCSG Partners Foundation

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Solange Peters, MD-PhD

Role: STUDY_CHAIR

Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland

Sabine Schmid, MD

Role: STUDY_CHAIR

Inselspital, Universitätsspital Bern, 3010 Bern, Switzerland

Paul Van Schil, MD-PhD

Role: STUDY_CHAIR

Antwerp University Hospital, Antwerp, Belgium,

Stephen Finn, MD-PhD

Role: STUDY_CHAIR

St. James's Hospital, Dublin 8, Ireland

Locations

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Chris O'Brien Lifehouse

Camperdown, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Nepean Hospital

Penrith, New South Wales, Australia

Site Status RECRUITING

Royal North Shore Hospital

St Leonards, New South Wales, Australia

Site Status RECRUITING

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status NOT_YET_RECRUITING

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status NOT_YET_RECRUITING

Royal Hobart Hospital

Hobart, Tasmania, Australia

Site Status NOT_YET_RECRUITING

Eastern Health

Box Hill, Victoria, Australia

Site Status RECRUITING

Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Peter MacCallum Cancer Centre

Parkville, Victoria, Australia

Site Status RECRUITING

Sir Charles Gairdner Hospital

Nedlands, Western Australia, Australia

Site Status NOT_YET_RECRUITING

Wien AKH

Vienna, , Austria

Site Status RECRUITING

Institut Jules Bordet - HUB

Anderlecht, , Belgium

Site Status RECRUITING

Antwerp University Hospital

Antwerp, , Belgium

Site Status RECRUITING

North Estonia Medical Centre Foundation

Talinn, , Estonia

Site Status RECRUITING

CHU Angers

Angers, , France

Site Status RECRUITING

Institut Bergonié

Bordeaux, , France

Site Status NOT_YET_RECRUITING

Le Mans - CHG

Le Mans, , France

Site Status RECRUITING

Lyon - Centre Léon Bérard

Lyon, , France

Site Status RECRUITING

Beaumont Hospital

Dublin, , Ireland

Site Status RECRUITING

St James's Hospital

Dublin, , Ireland

Site Status RECRUITING

SS Antonio e Biagio e Cesare Arrigo Hospital

Alessandria, , Italy

Site Status NOT_YET_RECRUITING

Istituto Oncologico Veneto

Padua, , Italy

Site Status NOT_YET_RECRUITING

Perugia Hospital

Perugia, , Italy

Site Status NOT_YET_RECRUITING

Istituto Nazionale Tumori "Regina Elena"

Rome, , Italy

Site Status RECRUITING

AOUS Policlinico Le Scotte

Siena, , Italy

Site Status NOT_YET_RECRUITING

Universita di Verona - Department of Medicine

Verona, , Italy

Site Status RECRUITING

NKI

Amsterdam, , Netherlands

Site Status NOT_YET_RECRUITING

UMCU

Utrecht, , Netherlands

Site Status RECRUITING

Kantonsspital Baden

Baden, , Switzerland

Site Status NOT_YET_RECRUITING

Universitätsspital Basel

Basel, , Switzerland

Site Status RECRUITING

Eoc - Iosi

Bellinzona, , Switzerland

Site Status NOT_YET_RECRUITING

Inselspital Bern

Bern, , Switzerland

Site Status RECRUITING

HFR Hôpital Fribourgeois

Fribourg, , Switzerland

Site Status RECRUITING

CHUV

Lausanne, , Switzerland

Site Status NOT_YET_RECRUITING

Kantonsspital St.Gallen

Sankt Gallen, , Switzerland

Site Status RECRUITING

Kantonsspital Winterthur

Winterthur, , Switzerland

Site Status RECRUITING

University Hospital Zurich

Zurich, , Switzerland

Site Status NOT_YET_RECRUITING

Barts Health NHS Trust

London, , United Kingdom

Site Status RECRUITING

Royal Marsden Hospital (Chelsea)

London, , United Kingdom

Site Status NOT_YET_RECRUITING

Royal Marsden Hospital (Sutton)

London, , United Kingdom

Site Status NOT_YET_RECRUITING

Maidstone and Tunbridge Wells NHS Trust

Maidstone, , United Kingdom

Site Status RECRUITING

Wythenshawe Hospital, Manchester University NHS Foundation Trust

Manchester, , United Kingdom

Site Status RECRUITING

Countries

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Australia Austria Belgium Estonia France Ireland Italy Netherlands Switzerland United Kingdom

Central Contacts

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Heidi Roschitzki, PhD

Role: CONTACT

+41 31 511 94 00

Susanne Roux

Role: CONTACT

+41 31 511 94 00

Facility Contacts

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Malinda Itchins

Role: primary

Deme Karikios

Role: primary

Malinda Itchins

Role: primary

Kenneth O'Bryne

Role: primary

Chris Karapetis

Role: primary

Rebecca Tay

Role: primary

Phillip Parente

Role: primary

Maggie Moore

Role: primary

Benjamin Solomon

Role: primary

Samantha Bowyer

Role: primary

Clemens Aigner

Role: primary

Mariana Brandao

Role: primary

Reinier Wener

Role: primary

Kersti Oselin

Role: primary

Youssef Oulkhouir

Role: primary

Sophie Cousin

Role: primary

Camille Guguen

Role: primary

Maurice Pérol

Role: primary

Jarushka Naidoo

Role: primary

Patrick Forde

Role: primary

Pier Luigi Piovano

Role: primary

Laura Bonnano

Role: primary

Giulio Metro

Role: primary

Landi Lorenza

Role: primary

Michele Maio

Role: primary

Lorenzo Belluomini

Role: primary

Willemijn Theelen

Role: primary

W.K. de Jong

Role: primary

Sacha Rothschild

Role: primary

David König

Role: primary

Martina Imbimbo

Role: primary

Sabine Schmid

Role: primary

Adrienne Bettini

Role: primary

Hasna Bouchaab

Role: primary

Martin Früh

Role: primary

Laetitia Mauti

Role: primary

Isabelle Opitz

Role: primary

Adam Januszewski

Role: primary

Sanjay Popat

Role: primary

Sanjay Popat

Role: primary

Riyaz Shah

Role: primary

Igor Randulfe

Role: primary

Other Identifiers

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ETOP 25-23

Identifier Type: -

Identifier Source: org_study_id

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