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RecruitingLast updated: 2 September 2025

TROPION-Lung15: This study is recruiting people with EGFR-mutated locally advanced or metastatic non-small cell lung cancer to assess the effectiveness an antibody-drug conjugate called Dato-DXd, with or without additional targeted therapy, compared to platinum-based doublet chemotherapyA Phase III, Open-label, Sponsor-blind, Randomized Study of Dato-DXd With or Without Osimertinib Versus Platinum-based Doublet Chemotherapy for Participants With EGFR-mutated Locally Advanced or Metastatic Non-small Cell Lung Cancer Whose Disease Has Progressed on Prior Osimertinib Treatment (TROPION-Lung15)

Trial purpose

Medical clipboardCancer treatment

Tumor type

Lung Cancers Lung cancer

Age

People18+

Trial acronym

TROPION-Lung15

Clinical summary

Summary

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

Group 1 will receive the antibody-drug conjugate Dato-DXd + osimertinib combination therapy. Dato-DXd will be given as an intravenous (IV) infusion on Day 1 of every 21-day cycle (every 3 weeks) and osimertinib will be given once daily as an oral tablet. 

Group 2 will receive Dato-DXd by itself (monotherapy), which will be given as an IV infusion every 3 weeks.

Group 3 will receive platinum-based doublet chemotherapy. This will consist of pemetrexed in combination with either carboplatin (AUC5) or cisplatin as IV infusion every 3 weeks for 4 cycles, followed by pemetrexed maintenance therapy as an IV infusion every 3 weeks. 

After study intervention discontinuation, all participants will undergo an end of treatment visit within 35 days of discontinuation and will be followed up for safety assessments 28 (+7) days after their last dose of study intervention. 

Conditions

This trial is treating people with non-squamous non-small cell lung cancer with EGFR mutation who have progressed on prior treatment with osimertinib

Eligibility

Inclusion

  • Histologically or cytologically confirmed non-squamous NSCLC.
  • Must have evidence of documented pre-existing EGFRm information (EGFRm known to be associated with (epidermal growth factor receptor [EGFR] tyrosine kinase inhibitor [TKis] sensitivity [Ex19del, L858R, G719X, S768I, or L861Q], either alone or in combination with other EGFR mutations, which may include T790M).
  • Documented extra-cranial radiologic progression on prior osimertinib monotherapy (as most recent line of treatment) in the adjuvant, locally advanced, or metastatic setting.
  • Less than or equal to (<=2) prior lines of EGFR TKIs (osimertinib is the only permitted prior third generation EGFR TKI).
  • At least one lesion, not previously irradiated, that qualifies as a RECIST v1.1 TL at baseline and can be accurately measured at baseline.
  • World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Adequate bone marrow reserve and organ function within 7 days before randomization.

Exclusion

  • Use of chemotherapy, vascular endothelial growth factor inhibitor, immunotherapy or any anti-cancer therapy in the metastatic setting. Platinum-based chemotherapy in non-metastatic setting within 12 months prior to randomization.
  • History of another primary malignancy except for malignancy treated with curative intent with no known active disease within 2 years before the first dose of study intervention.
  • Any evidence of severe or uncontrolled systemic diseases, including, but not limited to active bleeding diseases, active infection, active ILD/pneumonitis, cardiac disease.
  • Has significant third-space fluid retention (example [eg.], ascites or pleural effusion) as judged by the investigator and is not amenable for required repeated drainage.
  • History of non-infectious ILD/pneumonitis including radiation pneumonitis that required steroids or drug-induced ILD, 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.
  • Unstable spinal cord compression and/or unstable brain metastases.
  • Participants with symptomatic brain metastases (including leptomeningeal involvement).
  • Clinically significant corneal disease.
  • Uncontrolled infection requiring IV antibiotics, antivirals, or antifungals, suspected infections or inability to rule out infections.
  • Has known human immunodeficiency virus (HIV) infection that is not well controlled.

Inclusion

  • Your cancer has spread to other parts of the body (metastatic) or has grown into nearby parts of the body (locally advanced).
  • Your cancer has not spread to other parts of the body (localised).
  • Your cancer has not spread to other parts of the body, but it is not possible to perform surgery to remove it (unresectable).
  • You have had treatment but your cancer has gotten worse or has not responded to the treatment you have been given.
  • You are able to swallow medication by mouth.
  • You have had a certain type of treatment or surgical procedure.

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

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More information

Trial Identifiers

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

Trial sponsor

AstraZeneca

Scientific Title

A Phase III, Open-label, Sponsor-blind, Randomized Study of Dato-DXd With or Without Osimertinib Versus Platinum-based Doublet Chemotherapy for Participants With EGFR-mutated Locally Advanced or Metastatic Non-small Cell Lung Cancer Whose Disease Has Progressed on Prior Osimertinib Treatment (TROPION-Lung15)

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