Optimise viewing for

Toggle between patient and health professional views. The patient version is simplified to help people easily find suitable trials, while the professional view provides full detail.

RecruitingLast updated: 19 February 2026

TROPION-Lung10: Evaluating a treatment called Dato-DXd in combination with immunotherapy, compared to immunotherapy by itself, in people with locally advanced or metastatic non-squamous non-small cell lung cancer with high PD-L1 expression and without actionable genomic alterationsA Phase III, Randomised, Open-label, Global Study of Datopotamab Deruxtecan (Dato-DXd) in Combination With Rilvegostomig or Rilvegostomig Monotherapy Versus Pembrolizumab Monotherapy for the First-line Treatment of Participants With Locally-advanced or Metastatic Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations (TROPION-Lung10)

Trial purpose

Medical clipboardCancer treatment

Tumor type

Lung Cancers Lung cancer

Age

People18+

Trial acronym

TROPION-Lung10

Clinical summary

Summary

Eligible participants will be randomly allocated to one of three treatment arms.

In Arm 1 (Experimental), participants will receive the antibody drug conjugate called Datopotamab Deruxtecan (or Dato-DXd) in combination with Rilvegostomig immunotherapy. This will be given as an intravenous (IV) infusion every 3 weeks.

In Arm 2 (Experimental), participants will receive Rilvegostomig immunotherapy by itself (monotherapy), which will be given as an IV infusion every 3 weeks.

In Arm 3 (Active Comparator), participants will receive pembrolizumab immunotherapy as monotherapy, which will be given as an IV infusion every 3 weeks.

Conditions

This trial is treating people with Stage IIIB, IIIC or IV non-squamous non-small cell lung cancer with a high PD-L1 status (≥50%) and no actionable genomic alterations who have not had prior treatment for their advanced disease

Eligibility

Inclusion

  • Histologically or cytologically documented non-squamous NSCLC.
  • Stage IIIB or IIIC or Stage IV metastatic NSCLC (according to Edition 8 of the AJCC staging manual) not amenable to curative surgery or definitive chemoradiation.
  • Absence of sensitising EGFR mutations, and ALK and ROS1 rearrangements, and absence of documented local test result for any other known genomic alteration for which there are locally approved targeted first-line therapies.
  • Must provide tumor sample to determine PD-L1 status, TROP2 status and other biomarkers.
  • Known tumour PD-L1 expression status defined as TC ≥ 50%
  • At least one lesion, not previously irradiated that qualifies as a RECIST 1.1 target lesion at baseline
  • ECOG performance status of 0 or 1
  • Adequate bone marrow reserve and organ function within 7 days before the first dose of study intervention

Exclusion

  • Prior systemic therapy for advanced/metastatic NSCLC.
  • Squamous cell histology, or predominantly squamous cell histology NSCLC; mixed small cell lung cancer; NSCLC histology, sarcomatoid variant.
  • History of another primary malignancy within 3 years
  • Active or prior documented autoimmune or inflammatory disorders (with exceptions)
  • Any evidence of severe or uncontrolled systemic diseases, including, but not limited to active bleeding diseases, active infection, active ILD/pneumonitis, cardiac disease.
  • Has clinically significant third-space fluid retention (for example pleural effusion) and is not amenable for repeated drainage.
  • History of non-infectious ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at screening
  • Has severe pulmonary function compromise resulting from intercurrent pulmonary illnesses
  • Spinal cord compression, or brain metastases unless participant treated and no longer symptomatic, radiologically stable, and who require no treatment with corticosteroids or anticonvulsants.
  • History of leptomeningeal carcinomatosis
  • Known clinically significant corneal disease
  • Active infection with TB, HBV, HCV, Hepatitis A, or known HIV infection that is not well controlled
  • History of active primary immunodeficiency

Inclusion

  • Your cancer has spread to other parts of the body (metastatic) or has grown into nearby parts of the body (locally advanced).

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

Participating hospitals

Recruiting hospitals

+ Show non-recruiting hospitals

On hold hospitals

No longer recruiting (closed or complete) hospitals

InformationTell us if you find this trial availability is not accurate.Report inaccuracy

More information

Trial Identifiers

Information on this page is partially produced from ClinicalTrials.gov, EU Clinical Trials Register *. View further details about this trial on the registry via the links below:

Trial sponsor

AstraZeneca

Scientific Title

A Phase III, Randomised, Open-label, Global Study of Datopotamab Deruxtecan (Dato-DXd) in Combination With Rilvegostomig or Rilvegostomig Monotherapy Versus Pembrolizumab Monotherapy for the First-line Treatment of Participants With Locally-advanced or Metastatic Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations (TROPION-Lung10)

Get Support

Peer Connect

You might find it helpful to speak to someone who has 'been there before'. Our Peer Connect program can provide one-on-one phone support from someone who understands what you're going through and has clinical trials experience.

Know more about Peer Connect

Contact cancer support

If you need cancer information and practical support for yourself, a carer, family or friend, contact Cancer Council to speak with an experienced health professional on 13 11 20.

Get support

Multilingual information

Learn more about clinical trials through this collection of resources in languages other than English.

View information