# Perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer: the platform phase 2 NeoCOAST-2 trial

Source: https://onco.cc/key-papers/paper-nct05061550-nat-med-2025/  
OnCo record `paper-nct05061550-nat-med-2025` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Published report from the NeoCOAST-2 trial registered as NCT05061550, in Nature Medicine (2025), chosen as the most cited paper whose own text cites the registry id.

## Summary

In the phase II NeoCOAST-2 platform study, 202 patients with untreated, resectable stage IIA-IIIB non-small-cell lung cancer (NSCLC) were randomized to receive neoadjuvant durvalumab plus platinum-doublet chemotherapy with oleclumab, a CD73 inhibitor (Arm 1), or with monalizumab, a NKG2A inhibitor (Arm 2), or neoadjuvant durvalumab plus single-agent platinum chemotherapy with the TROP-2 antibody-drug conjugate (ADC) datopotamab deruxtecan (Arm 4), followed by surgical resection and adjuvant durvalumab with oleclumab or monalizumab (Arms 1 and 2) or durvalumab alone (Arm 4). Primary endpoints were pathological complete response (pCR) rate and safety; secondary endpoints included feasibility of surgery and major pathological response (mPR) rate. In the modified intention-to-treat population (n = 198; Arm 1, n = 74; Arm 2, n = 70; Arm 4, n = 54), pCR rates were 20.3% (15/74; 95% CI, 11.8-31.2), 25.7% (18/70; 95% CI, 16.0-37.6) and 35.2% (19/54; 95% CI, 22.7-49.4), and mPR rates were 41.9% (31/74; 95% CI, 30.5-53.9), 50.0% (35/70; 95% CI, 37.8-62.2) and 63.0% (34/54; 95% CI, 48.7-75.7) in arms 1, 2, and 4, respectively. In the safety population, 69/74 (93.2%), 66/71 (93.0%), and 51/54 (94.4%) patients underwent surgery, respectively. Overall, grade ≥3 treatment-related adverse events occurred in 27/74 (36.5%), 29/71 (40.8%) and 11/54 (20.4%) patients, respectively. In NeoCOAST-2, the first neoadjuvant trial examining an ADC plus chemo-immunotherapy in resectable NSCLC, pCR rates were highest in the datopotamab-deruxtecan-containing arm, warranting further investigation in larger trials of ADCs and checkpoint inhibition in the neoadjuvant setting. ClinicalTrials.gov identifier: NCT05061550.

Indexed on Europe PMC as PubMed record 40450142 (DOI 10.1038/s41591-025-03746-z). Its abstract cites the registry id NCT05061550, which is how it was matched to this trial; no figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: Nature Medicine
- Year: 2025
- DOI: 10.1038/s41591-025-03746-z
- Authors: Cascone T, Bonanno L, Guisier F, et al.
- What it means: This is the paper Europe PMC returns for registry id NCT05061550 with the most citations, so it is the natural first reading for anyone following the NeoCOAST-2 trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
- Caveats: Matched to the trial by the registry id cited in the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.

## Sources

- Nat Med 2025: https://doi.org/10.1038/s41591-025-03746-z
- PubMed: https://pubmed.ncbi.nlm.nih.gov/40450142/
- Europe PMC: https://europepmc.org/article/MED/40450142
- ClinicalTrials.gov NCT05061550: https://clinicaltrials.gov/study/NCT05061550

## Connected records

- trials: [Neoadjuvant and Adjuvant Treatment in Resectable Non-small Cell Lung Cancer](https://onco.cc/trials/nct05061550/)
- journals: [Nature Medicine](https://onco.cc/journals/nature-medicine/)

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