Hossein Borghaei, DO, MS, Discusses the TROPION-Lung04 Trial Rationale in NSCLC

CancerNetwork® spoke with Hossein Borghaei, DO, MS, of the Fox Chase Cancer Center and Thoracic Malignancies Chair for the journal ONCOLOGY®, about the actively recruiting TROPION-Lung04 study (NCT04612751) and the use of Datopotamab Deruxtecan (Dato-DXd) in combination with durvalumab (Imfinzi) for patients with advanced or metastatic non–small cell lung cancer. This ongoing phase 1 trial is examining how patients who were pretreated or are treatment naïve will respond to the combination with or without 4 cycles of platinum chemotherapy in the metastatic setting.

Transcript:

This is a trial in progress. The abstract was just to highlight that this study is ongoing, and Dato-DXd is an antibody drug conjugate which, as a single agent, has shown some clinical efficacy with good tolerability. The idea here is, as many other drugs have been developed in the world of lung cancer, if a drug or combination shows promising activity in a patient population who has evidence of disease progression after standard therapy, then we want to know if the drug combination for the patient in question can be moved into the frontline space. This [protocol] is taking advantage of that.

The idea here is that we know that a combination of chemotherapy plus immunotherapy has shown activity in almost all subgroups of patients, regardless of the level of PD-L1, and these are patients who don’t have any molecular drivers of the tumor. The question is, is the addition of Dato-DXd to the combination [able to potentially] improve clinical outcomes? The concept here is to simply evaluate the combination. Based on the fact that this was a trial in progress, I think that just sets up the rationale and idea as to why we want to do this. The trial should be in a good position to evaluate the role of Dato-DXd plus durvalumab in this sort of setting.

Reference

Borghaei H, Gutierrez M, Waqar S, et al. TROPION-Lung04: Datopotamab deruxtecan (Dato-DXd) plus durvalumab and platinum-based chemotherapy in advanced NSCLC. J Thor Oncol. 2021;16(suppl 10):S1098-S1099. doi.10.1016/j.jtho.2021.08.499