Durvalumab alone or in combination with oleclumab or monalizumab for unresectable stage III NSCLC

Consolidation treatment with durvalumab after concurrent chemoradiotherapy (cCRT) is standard of care for patients with unresectable, stage III NSCLC. Addition of immunomodulation through combination therapy may extend benefit to more patients. The multinational phase II COAST study randomized patients with unresectable, stage III NSCLC and no progression after cCRT 1:1:1 to durvalumab alone, durvalumab plus oleclumab (anti-CD73), or durvalumab plus monalizumab (anti-NKG2A). Confirmed objective response rate was numerically higher with durvalumab plus oleclumab (30.0%) and durvalumab plus monalizumab (35.5%) versus durvalumab alone (17.9%). Progression-free survival was prolonged with both combinations (HRs 0.44 and 0.42, respectively). Safety was similar across the arms.