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RecruitingNCT05061550NeoCOAST-2Updated Sep 23, 2026

Neoadjuvant and Adjuvant Treatment in Resectable Non-small Cell Lung Cancer

A Phase 2 interventional study of Durvalumab and Oleclumab in Non-small Cell Lung Cancer, sponsored by AstraZeneca. Recruiting at 97 sites in 12 countries. Open to participants aged 18 Years to 95 Years. Per ClinicalTrials.gov, last updated 2026-09-23.

Sponsored by AstraZeneca · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
630
Allocation
Randomized
Ages
18 Years to 95 Years
Sex
All
01

Study summary

The study is intended to assess the safety and efficacy of perioperative treatment with Durvalumab in combination with Oleclumab, Monalizumab, or AZD0171 and platinum doublet chemotherapy (CTX); or Volrustomig or Rilvegostomig in combination with CTX; or Datopotamab deruxtecan (Dato-DXd) in combination with Durvalumab or Rilvegostomig and single agent platinum chemotherapy in participants with resectable, early-stage non-small cell lung cancer.

Read the detailed description

This is an open-label, multi-arms, multicentre, randomised study, eligible participants will be enrolled and randomised to one of the following treatment regimens.

Arm 1: Participants will receive Oleclumab + durvalumab + CTX as neoadjuvant treatment and Oleclumab + durvalumab as adjuvant treatment.

Arm 2: Participants will receive Monalizumab + durvalumab + CTX as neoadjuvant treatment and Monalizumab + durvalumab as adjuvant treatment.

Arm 3: Participants will receive Volrustomig (Dose Exploration) + CTX as neoadjuvant treatment and Volrustomig as adjuvant treatment.

Arm 4: Participants will receive Dato-DXd + durvalumab + single agent platinum chemotherapy as neoadjuvant treatment and durvalumab as adjuvant treatment.

Arm 5: Participants will receive AZD0171 + durvalumab + CTX as neoadjuvant treatment and AZD0171 + durvalumab as adjuvant treatment.

Arm 6: Participants will receive Rilvegostomig + CTX as neoadjuvant treatment and Rilvegostomig as adjuvant treatment.

Arm 7: Participants will receive Dato-DXd + Rilvegostomig + single agent platinum chemotherapy as neoadjuvant treatment and Rilvegostomig as adjuvant treatment.

02

Conditions studied

  • Non-small Cell Lung Cancer

Keywords

  • Lung Cancer
  • early-stage
  • Durvalumab
  • Oleclumab
  • Monalizumab
  • AZD0171
  • Datopotamab Deruxtecan
  • Neoadjuvant
  • Adjuvant
  • Chemotherapy
  • Volrustomig
  • Rilvegostomig
03

Who can participate

Ages eligible
18 Years to 95 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Newly diagnosed NSCLC patients with resectable disease (Stage IIA to Stage IIIB).
  • WHO or Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Adequate organ and bone marrow function.
  • Provision of tumour samples (newly acquired or archival tumour tissue [≤ 6 months old]) to confirm Programmed death-ligand 1 (PD-L1) status, epidermal growth factor receptor (EGFR), or anaplastic lymphoma kinase (ALK) status.
  • Adequate pulmonary function.

Exclusion criteria

Exclusion Criteria:

  • Participants with sensitising EGFR mutations or ALK translocations.
  • Participants with baseline PD-L1 expression status \<1% (Arms 6 and 7 only).
  • Active or prior documented autoimmune or inflammatory disorders.
  • Uncontrolled intercurrent illness, uncontrolled hypertension, unstable angina pectoris, uncontrolled cardiac arrhythmia, active bleeding diseases, serious chronic gastrointestinal conditions associated with diarrhoea, or psychiatric illness/social situations that would limit compliance with study requirement.
  • History of another primary malignancy.
  • Participants with small-cell lung cancer or mixed small-cell lung cancer.
  • History of active primary immunodeficiency.
  • History of non-infectious interstitial lung disease (ILD) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at screening.
  • Participants who have preoperative radiotherapy treatment as part of their care plan.
  • Participants who require or may require pneumonectomy, segmentectomies, or wedge resections, as assessed by their surgeon at baseline, to obtain potentially curative resection of primary tumour.
  • QTcF (QT interval corrected by Fridericia's formula) interval ≥ 470 ms.
  • Any medical contraindication to treatment with chemotherapy as listed in the local labelling.
  • Participants with moderate or severe cardiovascular disease.
  • Any concurrent chemotherapy, investigational product, biologic, or hormonal therapy for cancer treatment.
  • Receipt of live attenuated vaccine within 30 days prior to the first dose of study interventions.
  • Prior exposure to approved or investigational immune-mediated therapy including, but not limited to, other anti-CTLA-4, anti-TIGIT (T cell immunoreceptor with Ig and ITIM domains), anti-PD-1, anti-PD-L1, and anti-PD-L2 antibodies. Participants who received agents targeting the adenosine pathway, anti-NKG2A, anti-HLA-E agents, and anti-LIF agents are also excluded. Participants who have received previous treatment with a TROP2 targeting ADC or with another ADC containing a chemotherapy agent that inhibits TOP1 activity are also excluded.
  • Current or prior use of immunosuppressive medication within 14 days before the first dose of study interventions.
  • Active or uncontrolled infections including HBA, HBV, HCV, and HIV.
04

Study design

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

Study arms

  • Experimental
    Arm 1: Oleclumab + Durvalumab + Platinum doublet chemotherapy (CTX)

    Participants will receive Durvalumab + Oleclumab + CTX as neoadjuvant treatment and Durvalumab + Oleclumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin

    Drug: Durvalumab · Drug: Oleclumab · Drug: Pemetrexed/Cisplatin · Drug: Pemetrexed/Carboplatin · Drug: Carboplatin/Paclitaxel

  • Experimental
    Arm 2: Monalizumab + Durvalumab + CTX

    Participants will receive Durvalumab + Monalizumab + CTX as neoadjuvant treatment and Durvalumab + Monalizumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin

    Drug: Durvalumab · Drug: Monalizumab · Drug: Pemetrexed/Cisplatin · Drug: Pemetrexed/Carboplatin · Drug: Carboplatin/Paclitaxel

  • Experimental
    Arm 3: Volrustomig (Dose Exploration) + CTX

    Participants will receive Volrustomig + CTX as neoadjuvant treatment and Volrustomig as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin

    Drug: Pemetrexed/Cisplatin · Drug: Pemetrexed/Carboplatin · Drug: Carboplatin/Paclitaxel · Drug: Volrustomig

  • Experimental
    Arm 4: Dato-DXd + durvalumab + single agent platinum

    Participants will receive Dato-DXd + durvalumab + single agent platinum as neoadjuvant treatment and durvalumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on physician choice of as part of their treatment regimen prior to surgery: Carboplatin or Cisplatin

    Drug: Durvalumab · Drug: Dato-DXd · Drug: Carboplatin · Drug: Cisplatin

  • Experimental
    Arm 5: AZD0171 + durvalumab + CTX

    Participants will receive AZD0171 + durvalumab + CTX as neoadjuvant treatment and AZD0171 + durvalumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin

    Drug: Durvalumab · Drug: AZD0171 · Drug: Pemetrexed/Cisplatin · Drug: Pemetrexed/Carboplatin · Drug: Carboplatin/Paclitaxel

  • Experimental
    Arm 6: Rilvegostomig + CTX

    Participants will receive Rilvegostomig + CTX as neoadjuvant treatment and Rilvegostomig as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin

    Drug: Pemetrexed/Cisplatin · Drug: Pemetrexed/Carboplatin · Drug: Carboplatin/Paclitaxel · Drug: Rilvegostomig

  • Experimental
    Arm 7: Dato-DXd + Rilvegostomig + single agent platinum

    Participants will receive Dato-DXd + Rilvegostomig + single agent platinum as neoadjuvant treatment and Rilvegostomig as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on physician choice of as part of their treatment regimen prior to surgery: Carboplatin or Cisplatin

    Drug: Dato-DXd · Drug: Carboplatin · Drug: Cisplatin · Drug: Rilvegostomig

Interventions

  • DrugDurvalumab

    Participants will receive Durvalumab via intravenous route.

    Also known as: MEDI4736, IMFINZI

  • DrugOleclumab

    Participants will receive Oleclumab via intravenous route.

    Also known as: MEDI9447

  • DrugMonalizumab

    Participants will receive Monalizumab via intravenous route.

    Also known as: IPH2201

  • DrugDato-DXd

    Participants will receive datopotamab deruxtecan (Dato-DXd) via intravenous route.

  • DrugAZD0171

    Participants will receive AZD0171 via intravenous route.

  • DrugCarboplatin

    Carboplatin as chemotherapy

  • DrugCisplatin

    Cisplatin as chemotherapy

  • DrugPemetrexed/Cisplatin

    Pemetrexed/Cisplatin as chemotherapy

  • DrugPemetrexed/Carboplatin

    Pemetrexed/Carboplatin as chemotherapy

  • DrugCarboplatin/Paclitaxel

    Carboplatin/Paclitaxel, as chemotherapy

  • DrugVolrustomig

    Participants will receive Volrustomig via intravenous route.

    Also known as: MEDI5752

  • DrugRilvegostomig

    Participants will receive Rilvegostomig via intravenous route.

05

What researchers measure

Primary outcomes

  1. Number of participants with pathological complete response (pCR)

    Time frame: From randomization to approximately 15 weeks after the first dose of study interventions

  2. Number of participants with adverse events (AEs) and serious adverse events (SAEs)

    Time frame: Until Day 90 after the last dose of study interventions (Up to approximately 3 years)

Secondary outcomes

  1. Number of participants experiencing an event-free survival (EFS) event

    Time frame: Up to approximately 3 years

  2. Number of participants experiencing a disease-free survival (DFS) event

    Time frame: Up to approximately 3 years

  3. Number of participants having surgical resection

    Time frame: From randomization to approximately 15 weeks after the first dose of study interventions

  4. Number of participants with major pathological response (mPR)

    Time frame: From randomization to approximately 15 weeks after the first dose of study interventions

  5. Number of participants with Objective response rate (ORR)

    Time frame: From randomization to approximately 15 weeks after the first dose of study interventions

  6. Overall survival (OS)

    Time frame: Up to approximately 3 years

  7. Serum concentration of study interventions (Durvalumab/Oleclumab/Monalizumab/Volrustomig/Rilvegostomig)

    Time frame: From randomization to last dose of study interventions (Up to approximately 3 Years)

  8. Number of participants with anti-study drug antibodies (ADA)

    Time frame: From randomization to 3 months after last dose of study interventions (Up to approximately 3 Years)

  9. Baseline PD-L1 expression

    Time frame: At Screening/ baseline

  10. Changes in circulating tumour DNA (ctDNA)

    Time frame: From randomization to up to 24 months after last dose of study interventions (Up to approximately 3 Years)

06

Study locations

81 of 97 sites recruiting
  • Research Site
    Little Rock, Arkansas 72205, United States
    Recruiting
  • Research Site
    Los Angeles, California 90095, United States
    Recruiting
  • Research Site
    Oakland, California 94611, United States
    Withdrawn
  • Research Site
    New Haven, Connecticut 06510, United States
    Recruiting
  • Research Site
    Stuart, Florida 34994, United States
    Completed
  • Research Site
    Gainesville, Georgia 30501, United States
    Withdrawn
  • Research Site
    Chicago, Illinois 60637, United States
    Recruiting
  • Research Site
    Baltimore, Maryland 21201, United States
    Withdrawn
  • Research Site
    Baltimore, Maryland 21231, United States
    Recruiting
  • Research Site
    Boston, Massachusetts 02215, United States
    Recruiting
  • Research Site
    Saint Louis Park, Minnesota 55426, United States
    Completed
  • Research Site
    Omaha, Nebraska 68124, United States
    Recruiting
  • Research Site
    Buffalo, New York 14263, United States
    Recruiting
  • Research Site
    Cleveland, Ohio 44195, United States
    Recruiting
  • Research Site
    Pittsburgh, Pennsylvania 15212, United States
    Recruiting
  • Research Site
    Chattanooga, Tennessee 37404, United States
    Recruiting
  • Research Site
    Memphis, Tennessee 38120, United States
    Recruiting
  • Research Site
    Nashville, Tennessee 37203, United States
    Withdrawn
  • Research Site
    Nashville, Tennessee 37203, United States
    Recruiting
  • Research Site
    Nashville, Tennessee 37232, United States
    Recruiting
  • Research Site
    Houston, Texas 77030, United States
    Recruiting
  • Research Site
    Houston, Texas 77090, United States
    Terminated
  • Research Site
    Fairfax, Virginia 22031, United States
    Recruiting
  • Research Site
    Edmonds, Washington 98026, United States
    Recruiting
  • Research Site
    Seattle, Washington 98104, United States
    Recruiting
  • Research Site
    Ghent, 9000, Belgium
    Recruiting
  • Research Site
    Ghent, 9000, Belgium
    Completed
  • Research Site
    Roeselare, 8800, Belgium
    Recruiting
  • Research Site
    Edmonton, Alberta T6G 1Z2, Canada
    Completed
  • Research Site
    Winnipeg, Manitoba R3E 0V9, Canada
    Recruiting
  • Research Site
    Montreal, Quebec H2W 1S6, Canada
    Recruiting
  • Research Site
    Montreal, Quebec H2X 3E4, Canada
    Recruiting
  • Research Site
    Avignon, 84902, France
    Recruiting
  • Research Site
    Bobigny, 93009, France
    Withdrawn
  • Research Site
    Bordeaux, 33076, France
    Recruiting
  • Research Site
    Limoges, 83000, France
    Recruiting
  • Research Site
    Rennes, 35000, France
    Recruiting
  • Research Site
    Rouen, 76031, France
    Recruiting
  • Research Site
    Suresnes, 92150, France
    Recruiting
  • Research Site
    Toulon, 83000, France
    Recruiting
  • Research Site
    Kecskemét, 6000, Hungary
    Recruiting
  • Research Site
    Székesfehérvár, 8000, Hungary
    Recruiting
  • Research Site
    Tatabánya, 2800, Hungary
    Completed
  • Research Site
    Törökbálint, 2045, Hungary
    Recruiting
  • Research Site
    Dublin, D07 R2WY, Ireland
    Recruiting
  • Research Site
    Dublin, D08 NHY1, Ireland
    Recruiting
  • Research Site
    Dublin, D09 V2N0, Ireland
    Recruiting
  • Research Site
    Galway, H91 YR71, Ireland
    Recruiting
  • Research Site
    Aviano, 33081, Italy
    Recruiting
  • Research Site
    Brescia, 25123, Italy
    Recruiting
  • Research Site
    Catanzaro, 88100, Italy
    Withdrawn
  • Research Site
    Florence, 50134, Italy
    Recruiting
  • Research Site
    Genova, 16100, Italy
    Recruiting
  • Research Site
    Meldola, 47014, Italy
    Recruiting
  • Research Site
    Milan, 20162, Italy
    Recruiting
  • Research Site
    Monza, 20900, Italy
    Recruiting
  • Research Site
    Padova, 35128, Italy
    Recruiting
  • Research Site
    Perugia, 06156, Italy
    Recruiting
  • Research Site
    Pisa, 56124, Italy
    Recruiting
  • Research Site
    Roma, 00144, Italy
    Recruiting
  • Research Site
    Rozzano, 20089, Italy
    Recruiting
  • Research Site
    Lisbon, 1099-023, Portugal
    Recruiting
  • Research Site
    Lisbon, 1169-050, Portugal
    Recruiting
  • Research Site
    Lisbon, 1400-038, Portugal
    Recruiting
  • Research Site
    Lisbon, 1500-650, Portugal
    Recruiting
  • Research Site
    Porto, 4099-001, Portugal
    Withdrawn
  • Research Site
    Porto, 4100-180, Portugal
    Completed
  • Research Site
    Porto, 4200-072, Portugal
    Recruiting
  • Research Site
    Busan, 48108, South Korea
    Completed
  • Research Site
    Chungcheongbuk-do, 28644, South Korea
    Withdrawn
  • Research Site
    Seongnam-si, 13496, South Korea
    Recruiting
  • Research Site
    Seoul, 03080, South Korea
    Recruiting
  • Research Site
    Seoul, 05505, South Korea
    Recruiting
  • Research Site
    Suwon, 16247, South Korea
    Recruiting
  • Research Site
    Suwon, 440-746, South Korea
    Recruiting
  • Research Site
    A Coruña, 15006, Spain
    Recruiting
  • Research Site
    Alicante, 03010, Spain
    Recruiting
  • Research Site
    Barcelona, 08036, Spain
    Recruiting
  • Research Site
    Barcelona, 8035, Spain
    Recruiting
  • Research Site
    Córdoba, 14004, Spain
    Recruiting
  • Research Site
    Madrid, 28040, Spain
    Recruiting
  • Research Site
    Majadahonda, 28250, Spain
    Recruiting
  • Research Site
    Málaga, 29010, Spain
    Recruiting
  • Research Site
    Reus, 43204, Spain
    Recruiting
  • Research Site
    Seville, 41009, Spain
    Recruiting
  • Research Site
    Terrassa, 08221, Spain
    Recruiting
  • Research Site
    Valencia, 46010, Spain
    Recruiting
  • Research Site
    Liuying, 736, Taiwan
    Recruiting
  • Research Site
    New Taipei City, 235, Taiwan
    Recruiting
  • Research Site
    Tainan, 70403, Taiwan
    Recruiting
  • Research Site
    Taipei, 10002, Taiwan
    Recruiting
  • Research Site
    Taipei, 11217, Taiwan
    Recruiting
  • Research Site
    Ankara, 06010, Turkey (Türkiye)
    Recruiting
  • Research Site
    Ankara, 06500, Turkey (Türkiye)
    Recruiting
  • Research Site
    Ankara, 06800, Turkey (Türkiye)
    Recruiting
  • Research Site
    Istanbul, 34722, Turkey (Türkiye)
    Recruiting
  • Research Site
    Izmir, 35575, Turkey (Türkiye)
    Recruiting
07

References and documents

Publications

  • Cascone T, Bonanno L, Guisier F, Insa A, Liberman M, Bylicki O, Livi L, Egenod T, Corre R, Kim DW, Garcia Campelo MR, Provencio Pulla M, Shim BY, Metro G, Bennouna J, Bielska AA, Yohannes AR, He Y, Dowson A, Kar G, McGrath L, Kumar R, Grenga I, Spicer J, Forde PM. Perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer: the platform phase 2 NeoCOAST-2 trial. Nat Med. 2025 Aug;31(8):2788-2796. doi: 10.1038/s41591-025-03746-z. Epub 2025 May 31. PubMed 40450142 ↗

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 Vivli.org. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. "Yes", indicates that AZ are accepting requests for IPD, but this does not mean all requests will be approved.

Supporting information: Study protocol, Sap

08

Registry details

Key details

Study ID
NCT05061550
Lead sponsor
AstraZeneca
Collaborators
Parexel
Responsible party
Sponsor
First posted
Sep 29, 2021
Start date
Apr 14, 2022
Primary completion
May 28, 2030 (estimated)
Completion
May 28, 2030 (estimated)
Last update
Sep 23, 2026

Study contacts

AstraZeneca Clinical Study Information Center
Contact
information.center@astrazeneca.com
1-877-240-9479
AstraZeneca Lung Cancer Study Locator Service
Contact
az-lcsl@careboxhealth.com
1-884-432-3892
Tina Cascone, MD
principal investigator · MD Anderson Cancer Center Houston, TX 77030

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
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