Oncology · 2 h ago
MDT-BRIDGE evaluates durvalumab-based treatment pathways in resectable NSCLC
In the nonrandomized, single-arm phase 2 MDT-BRIDGE trial, 142 patients with resectable or borderline resectable NSCLC received neoadjuvant durvalumab plus chemotherapy, with treatment reassessed by a multidisciplinary team. The overall resection rate was 74.6%; patients who became unresectable could receive chemoradiotherapy followed by durvalumab.
- Overall resection rate was 74.6% in 142 treated patients.
- More than one-third were borderline resectable at baseline.
- Most patients proceeded to surgery or chemoradiotherapy.
- Single-arm results do not establish comparative benefit.
MDT-BRIDGE is a global, nonrandomized phase 2 study of patients with stage IIB–IIIB, EGFR- and ALK-wild-type NSCLC assessed as resectable or borderline resectable. After two cycles of neoadjuvant durvalumab plus platinum-based chemotherapy, a multidisciplinary team reassessed patients. Those considered resectable continued treatment before surgery; those deemed unresectable received chemoradiotherapy (CRT). Durvalumab was planned after surgery or CRT. The primary endpoint was the overall resection rate; the study was descriptive and had no formal hypothesis testing.
Among 142 patients who received neoadjuvant treatment, 64.8% were considered resectable and 35.2% borderline resectable at baseline. The overall resection rate was 74.6% (95% CI, 66.7–81.6). Among patients who underwent surgery, the R0 resection rate was 96.2% (90.6–99.0). Overall, 131 patients (92.3%) proceeded to surgery (106) or CRT (25), and 117 (82.4%) received adjuvant or consolidation durvalumab. During durvalumab, maximum grade 3/4 adverse events occurred in 7.4% of resected patients and 17.4% of CRT-treated patients.
The findings suggest that MDT-guided treatment allocation was feasible in this study population, including patients with borderline resectable disease. The single-arm design, descriptive primary endpoint and preliminary efficacy assessment limit comparisons with other approaches; overall survival data were not yet mature.
In practice
For patients with stage IIB–IIIB NSCLC assessed as resectable or borderline resectable, this phase 2 study suggests that multidisciplinary reassessment after neoadjuvant durvalumab plus chemotherapy can support curative-intent surgery or, when disease is considered unresectable, CRT followed by durvalumab. The reported resection and safety findings are preliminary and come from a nonrandomized, single-arm study with a descriptive primary endpoint; they do not establish that this pathway is superior to alternatives or justify changing practice on their own.
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Nature Medicine: Neoadjuvant durvalumab plus chemotherapy in resectable or borderline resectable non-small-cell lung cancer: the phase 2 MDT-BRIDGE trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.