ClinicalTrials.gg
CompletedNCT03822351COASTUpdated Oct 8, 2024Results posted

Durvalumab Alone or in Combination With Novel Agents in Subjects With NSCLC

A Phase 2 interventional study of Durvalumab + Oleclumab and Durvalumab in Stage III Non-small Cell Lung Cancer and Unresectable, sponsored by MedImmune LLC. Completed at 73 sites in 9 countries. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2024-10-08.

Sponsored by MedImmune LLC (part of AstraZeneca) · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
189
Allocation
Randomized
Ages
18 Years to 99 Years
Sex
All
01

Study summary

The purpose of this study is to compare the clinical activity of durvalumab alone vs durvalumab in combination with novel agents. The overall study goal is early identification of novel durvalumab combinations that are more active than durvalumab alone in the treatment of patients with unresectable, Stage III NSCLC who have not progressed after cCRT.

Read the detailed description

Study D9108C00001 (COAST) is a Phase 2, open-label, multicenter, randomized multidrug platform study assessing the efficacy and safety of durvalumab alone vs durvalumab in combination with novel agents in subjects with locally advanced, unresectable, Stage III non-small cell lung cancer (NSCLC).

02

Conditions studied

  • Stage III Non-small Cell Lung Cancer
  • Unresectable

Keywords

  • Locally Advanced NSCLC
  • Non-small Cell Lung Cancer
  • Cancer
  • Lung
  • Unresectable
  • Stage III
03

In context

Carcinoma, Non-Small-Cell Lung

6,641 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,665 are open to participants now.

This study's enrollment of 189 is above the median of 62 across 5,327 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

MedImmune LLC is the lead sponsor of 270 studies on the registry; none are open to participants now.

Of its 52 completed or terminated interventional studies of FDA-regulated products, 29 (56%) have results posted.

First submitted after MedImmune LLC became part of AstraZeneca.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Main Inclusion Criteria:

  1. Written informed consent and any locally required authorization obtained from the subject prior to performing any protocol-related procedures, including screening evaluation
  2. Age 18 years or older
  3. Body weight ≥ 35 kg
  4. Subjects must have histologically or cytologically documented NSCLC who present with locally advanced, unresectable, Stage III disease
  5. Subjects must have completed, without progressing, definitive cCRT within 42 days prior to being randomized into the study
  6. Provision of tumor tissue sample, when available, from original diagnosis obtained before initiation of chemoradiotherapy
  7. Life expectancy ≥ 12 weeks
  8. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
  9. Subjects must have at least one previously irradiated tumor lesion that can be measured by RECIST v1.1

Main Exclusion Criteria:

  1. Mixed small cell and non-small cell lung cancer histology
  2. Current or prior use of immunosuppressive medication within 14 days before the first dose of study drug
  3. Prior exposure to any anti-PD1, anti-PD-L1, or anti-CTLA4 antibody for treatment of NSCLC
  4. Subjects with history of ≥ Grade 2 pneumonitis from prior chemoradiation therapy
  5. Subjects with a history of venous thrombosis within the past 3 months
  6. Subjects with history of myocardial infarction, transient ischemic attack, or stroke in the past 6 months
  7. Congestive heart failure
  8. Active or prior documented autoimmune or inflammatory disorders
  9. History of active primary immunodeficiency
  10. Active infection including tuberculosis, hepatitis B, hepatitis C, or human immunodeficiency virus (HIV)
  11. History of allogenic organ transplantation
  12. QTcF interval ≥ 470 ms
  13. History of another primary malignancy
  14. Concurrent enrollment in another clinical study [concurrent enrollment in an observational (non-interventional) clinical study or during the follow-up period of an interventional study is permitted]
  15. Females who are pregnant, lactating, or intend to become pregnant during their participation in the study
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
189 participants (actual)

Study arms

  • Experimental
    Control Arm (Durvalumab monotherapy)

    durvalumab IV

    Drug: Durvalumab

  • Experimental
    Arm A (durvalumab + oleclumab):

    durvalumab IV and oleclumab IV

    Drug: Durvalumab + Oleclumab

  • Experimental
    Arm B (durvalumab + monalizumab)

    durvalumab IV and monalizumab IV

    Drug: Durvalumab + Monalizumab

Interventions

  • DrugDurvalumab + Oleclumab

    Drug pages: Durvalumab · Oleclumab

    Durvalumab + Oleclumab

    Also known as: Durvalumab (MEDI-4736), Oleclumab (MEDI-9447)

  • Durvalumab

    Also known as: Durvalumab (MEDI-4736)

  • DrugDurvalumab + Monalizumab

    Drug pages: Durvalumab · Monalizumab

    Durvalumab + Monalizumab

    Also known as: Durvalumab (MEDI-4736), Monalizumab (IPH2201)

06

What researchers measure

Primary outcomes

  1. Objective Response (OR) Rate as a Measure of Antitumor Activity of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

    ORR was defined as the percentage of participants with at least one visit response of Complete Response (CR) or Partial Response (PR) per RECIST 1.1 for target lesions: CR: Disappearance of all target lesions; PR: \>=30% decrease in the sum of the longest diameter of target lesions; OR = CR + PR.

    Time frame: ORR at 16 weeks after randomization is the timing for radiologic assessment of the primary endpoint

Secondary outcomes

  1. Presence of Adverse Events as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents

    The secondary endpoint of safety as assessed by the presence of adverse events and serious adverse events

    Time frame: From time of signature of informed consent up to 15 months post the first dose of study treatment

  2. Presence of Clinically Significant Laboratory Values as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents

    The secondary endpoint of safety as assessed by the presence of Grade 3 or 4 clinical laboratory toxicities (based on NCI-CTCAE v5.0) in chemistry and hematology values

    Time frame: From baseline up to 15 months post the first dose of study treatment

  3. Presence of Abnormalities in Vital Signs as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents

    The secondary endpoint of safety as assessed by the presence of abnormal vital signs reported as adverse events

    Time frame: From baseline up to 15 months post the first dose of study treatment

  4. Duration of Response (DoR) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

    The duration from the first documentation of a subsequently confirmed OR to the first documentation of a disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first. Only participants who have achieved OR (confirmed CR or confirmed PR) will be evaluated for DoR

    Time frame: Up to approximately 54 months (through the database cutoff date of 18-Jul-2023).

  5. Disease Control (DC) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

    Disease control rate (DCR) was defined as the percentage of participants with a BOR of confirmed CR, confirmed PR, or SD (maintained for ≥ 16 weeks) based on RECIST v1.1.

    Time frame: Up to approximately 54 months (through the database cutoff date of 18-Jul-2023).

  6. Progression-Free Survival (PFS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

    PFS was defined as the time from randomization until the first documentation of disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first

    Time frame: Up to approximately 54 months (through the database cutoff date of 18-Jul-2023).

  7. Progression-Free Survival 12 Month Landmark Rate (PFS-12) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

    PFS-12 was defined as the percentage of participants who were alive and progression free at 12 months after randomization.

    Time frame: PFS rate at 12 months after randomization.

  8. Overall Survival (OS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

    OS was defined as the time from the date of randomization until death due to any cause.

    Time frame: From time of randomization until death due to any cause. Assessed through the database cutoff date of 18-Jul-2023).

  9. Pharmacokinetics of Durvalumab Alone and in Combination With Novel Agents

    Geometric mean serum concentrations of durvalumab (μg/mL) were reported for each time point where data warrant, as appropriate.

    Time frame: From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose and at end of infusion, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1

  10. Pharmacokinetics of Novel Agents in Combination With Durvalumab

    Geometric mean serum concentrations of oleclumab (μg/mL) and monalizumab (μg/mL) were reported for each time point where data warrant, as appropriate.

    Time frame: From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose and at end of infusion, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1

  11. Presence of Detectable Anti-Drug Antibody (ADA) Response to Durvalumab Alone and in Combination With Novel Agents

    ADA prevalence was defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. ADA positive post-baseline only was also referred to as treatment-induced ADA positive. Treatment-boosted ADA was defined as baseline positive ADA titer that was boosted to a 4-fold or higher following drug administration. Persistently positive was defined as positive at ≥2 post-baseline assessments (with ≥16 weeks between first and last positive) or positive at last post-baseline assessment. Transiently positive was defined as having at least 1 post-baseline ADA positive assessment and not fulfilling the conditions of persistently positive. ADA incidence (treatment-emergent ADA positive) was defined as the sum of treatment-induced ADA and treatment-boosted ADA.

    Time frame: From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1

  12. Presence of Detectable Anti-Drug Antibody (ADA) Response to Novel Agents in Combination With Durvalumab

    ADA prevalence was defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. ADA positive post-baseline only was also referred to as treatment-induced ADA positive. Treatment-boosted ADA was defined as baseline positive ADA titer that was boosted to a 4-fold or higher following drug administration. Persistently positive was defined as positive at ≥2 post-baseline assessments (with ≥16 weeks between first and last positive) or positive at last post-baseline assessment. Transiently positive was defined as having at least 1 post-baseline ADA positive assessment and not fulfilling the conditions of persistently positive. ADA incidence (treatment-emergent ADA positive) was defined as the sum of treatment-induced ADA and treatment-boosted ADA.

    Time frame: From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1

07

Results

Posted Oct 8, 2024

Participant flow

The first participant was randomized into the study on 3 January 2019 and the last participant was randomized on 6 July 2020.

Participant flow — Overall Study
MilestoneControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Started676062
Completed212930
Not completed463132
Withdrew: Death272324
Withdrew: Lost to follow-up621
Withdrew: Withdrawal by subject1046
Withdrew: Progressive disease210
Withdrew: Not treated111

Outcome measures

PrimaryObjective Response (OR) Rate as a Measure of Antitumor Activity of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

ORR was defined as the percentage of participants with at least one visit response of Complete Response (CR) or Partial Response (PR) per RECIST 1.1 for target lesions: CR: Disappearance of all target lesions; PR: \>=30% decrease in the sum of the longest diameter of target lesions; OR = CR + PR.

Time frame:
ORR at 16 weeks after randomization is the timing for radiologic assessment of the primary endpoint
Reported as:
Number · Percentage of Participants
Objective Response (OR) Rate as a Measure of Antitumor Activity of Durvalumab Alone vs Durvalumab in Combination With Novel Agents
Percentage of ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Objective Response (OR) Rate as a Measure of Antitumor Activity of Durvalumab Alone vs Durvalumab in Combination With Novel Agents23.9 (14.3 to 35.9)35.0 (23.1 to 48.4)40.3 (28.1 to 53.6)
SecondaryPresence of Adverse Events as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents

The secondary endpoint of safety as assessed by the presence of adverse events and serious adverse events

Time frame:
From time of signature of informed consent up to 15 months post the first dose of study treatment
Reported as:
Count of participants · Participants
Presence of Adverse Events as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents
ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Participants with any TEAEs655761
Participants with any serious TEAEs232017
SecondaryPresence of Clinically Significant Laboratory Values as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents

The secondary endpoint of safety as assessed by the presence of Grade 3 or 4 clinical laboratory toxicities (based on NCI-CTCAE v5.0) in chemistry and hematology values

Time frame:
From baseline up to 15 months post the first dose of study treatment
Reported as:
Count of participants · Participants
Presence of Clinically Significant Laboratory Values as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents
ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Participants with any Grade 3 or 4 Alanine Aminostransferase (U/L) toxicities100
Participants with any Grade 3 or 4 Albumin (g/dL) toxicities200
Participants with any Grade 3 or 4 Amylase (U/L) toxicities102
Participants with any Grade 3 or 4 Aspartate Aminotransferase (U/L) toxicities101
Participants with any Grade 3 or 4 Creatinine (mg/dL) toxicities100
Participants with any Grade 3 or 4 Creatinine Clearance Rate (mL/min) toxicities210
Participants with any Grade 3 or 4 Gamma Glutamyl Transferase (U/L) toxicities100
Participants with any Grade 3 or 4 Hyperkalemia (mEq/L) toxicities002
Participants with any Grade 3 or 4 Hypokalemia (mEq/L) toxicities101
Participants with any Grade 3 or 4 Hypocalcemia (corrected) (mg/dL) toxicities100
Participants with any Grade 3 or 4 Hypernatremia (mEq/L) toxicities121
Participants with any Grade 3 or 4 Lipase (U/L) toxicities142
Participants with any Grade 3 or 4 Hemoglobin increased (g/dL) toxicities300
Participants with any Grade 3 or 4 Lymphocyte count increased (10^3/uL) toxicities191111
Participants with any Grade 3 or 4 Platelet count decreased (10^3/uL) toxicities100
SecondaryPresence of Abnormalities in Vital Signs as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents

The secondary endpoint of safety as assessed by the presence of abnormal vital signs reported as adverse events

Time frame:
From baseline up to 15 months post the first dose of study treatment
Reported as:
Count of participants · Participants
Presence of Abnormalities in Vital Signs as a Measure of Safety and Tolerability of Durvalumab Alone and in Combination With Novel Agents
ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Hypertension330
Hypotension203
Palpitations001
Pyrexia6810
Tachycardia122
SecondaryDuration of Response (DoR) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

The duration from the first documentation of a subsequently confirmed OR to the first documentation of a disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first. Only participants who have achieved OR (confirmed CR or confirmed PR) will be evaluated for DoR

Time frame:
Up to approximately 54 months (through the database cutoff date of 18-Jul-2023).
Reported as:
Median · Months
Duration of Response (DoR) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents
MonthsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Duration of Response (DoR) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel AgentsNA (14.1 to NA)29.9 (17.1 to NA)23.0 (10.2 to NA)
SecondaryDisease Control (DC) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

Disease control rate (DCR) was defined as the percentage of participants with a BOR of confirmed CR, confirmed PR, or SD (maintained for ≥ 16 weeks) based on RECIST v1.1.

Time frame:
Up to approximately 54 months (through the database cutoff date of 18-Jul-2023).
Reported as:
Number · Percentage of Participants
Disease Control (DC) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents
Percentage of ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Disease Control (DC) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents58.2 (45.5 to 70.2)80.0 (67.7 to 89.2)79.0 (66.8 to 88.3)
SecondaryProgression-Free Survival (PFS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

PFS was defined as the time from randomization until the first documentation of disease progression according to RECIST v1.1 or death due to any cause, whichever occurs first

Time frame:
Up to approximately 54 months (through the database cutoff date of 18-Jul-2023).
Reported as:
Median · Months
Progression-Free Survival (PFS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents
MonthsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Progression-Free Survival (PFS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents7.3 (4.0 to 13.8)21.1 (10.4 to 30.9)19.8 (13.6 to 31.3)
SecondaryProgression-Free Survival 12 Month Landmark Rate (PFS-12) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

PFS-12 was defined as the percentage of participants who were alive and progression free at 12 months after randomization.

Time frame:
PFS rate at 12 months after randomization.
Reported as:
Number · Percentage of Participants
Progression-Free Survival 12 Month Landmark Rate (PFS-12) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents
Percentage of ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Progression-Free Survival 12 Month Landmark Rate (PFS-12) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents37.6 (24.7 to 50.4)63.5 (49.2 to 74.7)73.2 (59.6 to 82.9)
SecondaryOverall Survival (OS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents

OS was defined as the time from the date of randomization until death due to any cause.

Time frame:
From time of randomization until death due to any cause. Assessed through the database cutoff date of 18-Jul-2023).
Reported as:
Median · Months
Overall Survival (OS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents
MonthsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Overall Survival (OS) as a Measure of Efficacy of Durvalumab Alone vs Durvalumab in Combination With Novel Agents40.9 (22.6 to NA)NA (31.9 to NA)NA (31.3 to NA)
SecondaryPharmacokinetics of Durvalumab Alone and in Combination With Novel Agents

Geometric mean serum concentrations of durvalumab (μg/mL) were reported for each time point where data warrant, as appropriate.

Time frame:
From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose and at end of infusion, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1
Reported as:
Geometric mean · Micrograms per milliliter
Pharmacokinetics of Durvalumab Alone and in Combination With Novel Agents
Micrograms per milliliterControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Cycle 1 Day 1: End of Infusion318.0 ± 199.6277.4 ± 316.1223.7 ± 1272
Cycle 2 Day 1: Pre-Dose59.7 ± 58.668.0 ± 49.974.3 ± 40.7
Cycle 7 Day 1: Pre-Dose151.6 ± 37.7127.9 ± 66.4176.5 ± 45.6
Cycle 11 Day 1: Pre-Dose156.7 ± 50.0146.5 ± 91.3172.4 ± 40.4
SecondaryPharmacokinetics of Novel Agents in Combination With Durvalumab

Geometric mean serum concentrations of oleclumab (μg/mL) and monalizumab (μg/mL) were reported for each time point where data warrant, as appropriate.

Time frame:
From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose and at end of infusion, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1
Reported as:
Geometric mean · Micrograms per milliliter
Pharmacokinetics of Novel Agents in Combination With Durvalumab
Micrograms per milliliterArm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
Cycle 1 Day 1: End of Infusion581.6 ± 210.5160.0 ± 286.4
Cycle 2 Day 1: Pre-Dose216.4 ± 58.6102.6 ± 39.2
Cycle 7 Day 1: Pre-Dose124.5 ± 109.0194.5 ± 33.8
Cycle 11 Day 1: Pre-Dose132.0 ± 166.8196.2 ± 48.7
SecondaryPresence of Detectable Anti-Drug Antibody (ADA) Response to Durvalumab Alone and in Combination With Novel Agents

ADA prevalence was defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. ADA positive post-baseline only was also referred to as treatment-induced ADA positive. Treatment-boosted ADA was defined as baseline positive ADA titer that was boosted to a 4-fold or higher following drug administration. Persistently positive was defined as positive at ≥2 post-baseline assessments (with ≥16 weeks between first and last positive) or positive at last post-baseline assessment. Transiently positive was defined as having at least 1 post-baseline ADA positive assessment and not fulfilling the conditions of persistently positive. ADA incidence (treatment-emergent ADA positive) was defined as the sum of treatment-induced ADA and treatment-boosted ADA.

Time frame:
From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1
Reported as:
Count of participants · Participants
Presence of Detectable Anti-Drug Antibody (ADA) Response to Durvalumab Alone and in Combination With Novel Agents
ParticipantsControl Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
ADA positive at any visit (ADA prevalence)312
Treatment-emergent ADA positive (ADA incidence)100
Treatment-boosted ADA000
Treatment-induced ADA (positive post-baseline only)100
ADA positive at baseline only212
ADA positive post-baseline and positive at baseline000
Persistently positive100
Transiently positive000
SecondaryPresence of Detectable Anti-Drug Antibody (ADA) Response to Novel Agents in Combination With Durvalumab

ADA prevalence was defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. ADA positive post-baseline only was also referred to as treatment-induced ADA positive. Treatment-boosted ADA was defined as baseline positive ADA titer that was boosted to a 4-fold or higher following drug administration. Persistently positive was defined as positive at ≥2 post-baseline assessments (with ≥16 weeks between first and last positive) or positive at last post-baseline assessment. Transiently positive was defined as having at least 1 post-baseline ADA positive assessment and not fulfilling the conditions of persistently positive. ADA incidence (treatment-emergent ADA positive) was defined as the sum of treatment-induced ADA and treatment-boosted ADA.

Time frame:
From randomization up to 15 months after first treatment: Cycle 1 Day 1 pre-dose, Cycle 2 Day 1 pre-dose (1 month), Cycle 7 Day 1 pre-dose (6 months), Cycle 11 Day 1 pre-dose (10 months) and 15 months post Cycle 1 Day 1
Reported as:
Count of participants · Participants
Presence of Detectable Anti-Drug Antibody (ADA) Response to Novel Agents in Combination With Durvalumab
ParticipantsArm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)
ADA positive at any visit (ADA prevalence)01
Treatment-emergent ADA positive (ADA incidence)01
Treatment-boosted ADA00
Treatment-induced ADA (positive post-baseline only)01
ADA positive at baseline only00
ADA positive post-baseline and positive at baseline00
Persistently positive00
Transiently positive01

Adverse events

Collected over AEs and SAEs were collected from time of signature of informed consent up to 15 months post the first dose of study treatment. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Durvalumab Monotherapy27/66 (40.9%)23/66 (34.8%)61/66 (92.4%)
Durvalumab + Oleclumab23/59 (39%)20/59 (33.9%)52/59 (88.1%)
Durvalumab + Monalizumab24/61 (39.3%)17/61 (27.9%)58/61 (95.1%)
Most frequent serious events
Showing 10 of 56
Most frequent serious events
EventDurvalumab MonotherapyDurvalumab + OleclumabDurvalumab + Monalizumab
PneumonitisRespiratory, thoracic and mediastinal disorders3/666/592/61
PneumoniaInfections and infestations5/664/590/61
Radiation pneumonitisInjury, poisoning and procedural complications1/662/590/61
SeizureNervous system disorders2/660/590/61
Acute respiratory failureRespiratory, thoracic and mediastinal disorders2/660/591/61
Pleural effusionRespiratory, thoracic and mediastinal disorders2/661/590/61
PyrexiaGeneral disorders0/661/591/61
Sudden deathGeneral disorders0/661/590/61
AppendicitisInfections and infestations0/661/590/61
Enterocolitis infectiousInfections and infestations0/661/590/61
Most frequent other events
Showing 10 of 55
Most frequent other events
EventDurvalumab MonotherapyDurvalumab + OleclumabDurvalumab + Monalizumab
CoughRespiratory, thoracic and mediastinal disorders11/6619/5926/61
DyspnoeaRespiratory, thoracic and mediastinal disorders17/6615/5914/61
PruritusSkin and subcutaneous tissue disorders7/6610/5915/61
AstheniaGeneral disorders10/6611/5915/61
HypothyroidismEndocrine disorders10/668/5913/61
DiarrhoeaGastrointestinal disorders7/668/5913/61
ArthralgiaMusculoskeletal and connective tissue disorders11/6610/5911/61
RashSkin and subcutaneous tissue disorders6/669/598/61
ConstipationGastrointestinal disorders10/664/592/61
PyrexiaGeneral disorders6/667/599/61

Baseline characteristics

The Intent-to-treat (ITT) population included participants who were randomized and were analyzed according to their randomized treatment group

Age, Continuous
Age, Continuous(years)Control Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)Total
Mean65.5 ± 8.963.8 ± 9.564.4 ± 9.264.6 ± 9.2
Sex: Female, Male
Sex: Female, Male(Participants)Control Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)Total
Female22182060
Male454242129
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Control Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)Total
Hispanic or Latino3328
Not Hispanic or Latino635659178
Unknown or Not Reported1113
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Control Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)Total
American Indian or Alaska Native0101
Asian54514
Black or African American1528
Native Hawaiian or Other Pacific Islander1001
White574755159
Other1203
Missing2103
Region of Enrollment
Region of Enrollment(Participants)Control Arm (Durvalumab Monotherapy)Arm A (Durvalumab + Oleclumab)Arm B (Durvalumab + Monalizumab)Total
Canada3216
France1519539
Hong-Kong1236
Italy0336
Portugal3036
Spain19122253
Taiwan1012
United States25222471
08

Study locations

73 sites
  • Research Site
    Anaheim, California 92801, United States
  • Research Site
    Duarte, California 91010, United States
  • Research Site
    Sacramento, California 95825, United States
  • Research Site
    New Haven, Connecticut 06510, United States
  • Research Site
    West Haven, Connecticut 06516, United States
  • Research Site
    Washington D.C., District of Columbia 20007, United States
  • Research Site
    Orlando, Florida 32804, United States
  • Research Site
    Winter Haven, Florida 33881, United States
  • Research Site
    Wichita, Kansas 67214, United States
  • Research Site
    Lexington, Kentucky 40503, United States
  • Research Site
    Louisville, Kentucky 40202, United States
  • Research Site
    Baton Rouge, Louisiana 70809, United States
  • Research Site
    Covington, Louisiana 70433, United States
  • Research Site
    Rosedale, Maryland 21237, United States
  • Research Site
    Lincoln, Nebraska 68510, United States
  • Research Site
    New York, New York 10029, United States
  • Research Site
    New York, New York 10065, United States
  • Research Site
    Portland, Oregon 97227-1191, United States
  • Research Site
    Gettysburg, Pennsylvania 17325, United States
  • Research Site
    Lancaster, Pennsylvania 17601, United States
  • Research Site
    Philadelphia, Pennsylvania 19104, United States
  • Research Site
    Sioux Falls, South Dakota 57105, United States
  • Research Site
    Germantown, Tennessee 38138, United States
  • Research Site
    Memphis, Tennessee 38120, United States
  • Research Site
    Tyler, Texas 75701, United States
  • Research Site
    Salt Lake City, Utah 84112, United States
  • Research Site
    Richmond, Virginia 23230, United States
  • Research Site
    Tacoma, Washington 98405, United States
  • Research Site
    Edmonton, Alberta T6G 1Z2, Canada
  • Research Site
    Toronto, Ontario M5G 2M9, Canada
  • Research Site
    Montreal, Quebec H4A 3J1, Canada
  • Research Site
    Bordeaux, 33076, France
  • Research Site
    Brest, 29609, France
  • Research Site
    Bron, 69677, France
  • Research Site
    Créteil, 94010, France
  • Research Site
    La Rochelle, 17019, France
  • Research Site
    Lille, 59037, France
  • Research Site
    Limoges, 87042, France
  • Research Site
    Lyon, 69004, France
  • Research Site
    Marseille, 13015, France
  • Research Site
    Nice, 06189, France
  • Research Site
    Pierre-Bénite, 69495, France
  • Research Site
    Rennes, 35033, France
  • Research Site
    Strasbourg, 67065, France
  • Research Site
    Toulouse, 31059, France
  • Research Site
    Hong Kong, Hong Kong
  • Research Site
    Jordan, Hong Kong
  • Research Site
    Kowloon, Hong Kong
  • Research Site
    Catania, 95125, Italy
  • Research Site
    Cremona, 26100, Italy
  • Research Site
    Milan, 20132, Italy
  • Research Site
    Milan, 20133, Italy
  • Research Site
    Palermo, 90127, Italy
  • Research Site
    Ravenna, 48121, Italy
  • Research Site
    Siena, 53100, Italy
  • Research Site
    Gdynia, 81-519, Poland
  • Research Site
    Lodz, 90-153, Poland
  • Research Site
    Lodz, 90-242, Poland
  • Research Site
    Lisbon, 1400-038, Portugal
  • Research Site
    Lisbon, 1500-650, Portugal
  • Research Site
    Porto, 4099-001, Portugal
  • Research Site
    Porto, 4200-072, Portugal
  • Research Site
    A Coruña, 15006, Spain
  • Research Site
    Badajoz, 06008, Spain
  • Research Site
    Barcelona, 08035, Spain
  • Research Site
    Barcelona, 08041, Spain
  • Research Site
    Barcelona, 08916, Spain
  • Research Site
    Castellon, 12002, Spain
  • Research Site
    Madrid, 28034, Spain
  • Research Site
    Málaga, 29010, Spain
  • Research Site
    Valencia, 46014, Spain
  • Research Site
    Chiayi City, 61363, Taiwan
  • Research Site
    Taichung, 402, Taiwan
09

References and documents

Publications

  • Aggarwal C, Martinez-Marti A, Majem M, Barlesi F, Carcereny E, Chu Q, Monnet I, Sanchez-Hernandez A, Dakhil S, Camidge DR, Pillet M, Brown M, Paliompeis C, Dowson A, Cooper ZA, Kumar R, Herbst RS. Durvalumab Alone or Combined With Novel Agents for Unresectable Stage III Non-Small Cell Lung Cancer: Update From the COAST Randomized Clinical Trial. JAMA Netw Open. 2025 Jul 1;8(7):e2518440. doi: 10.1001/jamanetworkopen.2025.18440. PubMed 40663352 ↗
  • Herbst RS, Majem M, Barlesi F, Carcereny E, Chu Q, Monnet I, Sanchez-Hernandez A, Dakhil S, Camidge DR, Winzer L, Soo-Hoo Y, Cooper ZA, Kumar R, Bothos J, Aggarwal C, Martinez-Marti A. COAST: An Open-Label, Phase II, Multidrug Platform Study of Durvalumab Alone or in Combination With Oleclumab or Monalizumab in Patients With Unresectable, Stage III Non-Small-Cell Lung Cancer. J Clin Oncol. 2022 Oct 10;40(29):3383-3393. doi: 10.1200/JCO.22.00227. Epub 2022 Apr 22. PubMed 35452273 ↗

Study documents

  • Study protocol · Jul 27, 2021
  • Statistical analysis plan · Sep 4, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Supporting information: Study protocol, Statistical analysis plan

Time frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Access criteria: When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Data sharing details ↗ · astrazenecagroup-dt.pharmacm.com

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Dec 2018 to primary completion in Jul 2023, 54 months.

Results were first posted in Oct 2024, 1 year 2 months after primary completion.

Of 292 industry-sponsored phase 2 interventional studies under Carcinoma, Non-Small-Cell Lung, half reached primary completion within 34 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 59. This study's 54 months is above that.

Counting every sponsor, half of 970 studies reached it within 48 months; a quarter within 30 and three quarters within 75.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 10, 2018
First posted
Jan 30, 2019
StartActual
Dec 19, 2018
Primary completionActual
Jul 18, 2023
CompletionActual
Jul 18, 2023
Results first posted
Oct 8, 2024
Last update
Oct 8, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 8, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03822351
Lead sponsor
MedImmune LLC
Responsible party
Sponsor
First posted
Jan 30, 2019
Start date
Dec 19, 2018
Primary completion
Jul 18, 2023
Completion
Jul 18, 2023
Results posted
Oct 8, 2024
Last update
Oct 8, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2024. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drugs tested here: Durvalumab · Oleclumab · Monalizumab

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