Clinical outcomes by type of surgery with perioperative durvalumab in patients with resectable non-small cell lung cancer
In brief
Durvalumab raises lobectomy complete response to 21% versus 5% with chemo alone
In the AEGEAN phase 3 trial, adding perioperative durvalumab to neoadjuvant chemotherapy increased pathological complete response rates across all surgery types, most notably from 5% to 21% after lobectomy. Event-free survival also improved, and severe surgical complications remained low, suggesting the benefit persists regardless of resection method.
- Journal
- The Journal of thoracic and cardiovascular surgery (Q1)
- Published
- 3 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- David Harpole, John V Heymach, Martin Reck, Janis Taube, Shugeng Gao, Gaofeng Li, et al.
- PMID
- 42692248
- DOI
- 10.1016/j.jtcvs.2026.04.058
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (top studies of the week, 6 September 2026): Arthroscopic tissue biopsy diagnostic accuracy for PJI
- Picked for Oncology and Radiation Oncology (top studies of the week, 6 September 2026): Phase 3 perioperative durvalumab trial in resectable NSCLC
Abstract
OBJECTIVE: To assess outcomes with perioperative durvalumab by type of surgery in patients with resectable non-small cell lung cancer (NSCLC) from the AEGEAN study. METHODS: AEGEAN is a double-blind, placebo-controlled phase 3 study (NCT03800134) of adults with treatment-naïve, resectable NSCLC (stage II-IIIB[N2]) who were randomized 1:1 to neoadjuvant chemotherapy plus durvalumab or placebo before surgery followed by adjuvant durvalumab or placebo. PRIMARY ENDPOINTS: pathological complete response (pCR) and event-free survival (EFS) in the modified intent-to-treat (mITT) population, which excluded patients with documented EGFR/ALK aberrations. RESULTS: Of 295 and 302 patients in the durvalumab and placebo arms, respectively, who underwent surgery (mITT population), 80.7% versus 73.2% had lobectomy, 7.5% versus 12.3% had sleeve resection/bilobectomy, and 9.2% versus 9.6% had pneumonectomy. pCR rates were higher in the durvalumab versus placebo arm, regardless of surgery type (lobectomy: 21.0% vs 5.4%; sleeve resection/bilobectomy: 36.4% vs 5.4%; and pneumonectomy: 7.4% vs 3.4%). EFS benefit favored the durvalumab versus placebo arm, regardless of surgery type (lobectomy: hazard ratio [HR], 0.64 [95% confidence interval (CI), 0.46-0.88; sleeve resection/bilobectomy: HR, 0.59 [95% CI, 0.22-1.40]; and pneumonectomy: HR, 0.80 [95% CI, 0.36-1.74]). The rates of maximum grade ≥3 surgical complications were low across both arms, regardless of surgery type (lobectomy: 4.2% vs 9.5%; sleeve resection/bilobectomy: 13.6% vs 5.4%; and pneumonectomy: 14.8% vs 6.9%). CONCLUSIONS: Clinical benefit with perioperative durvalumab plus neoadjuvant chemotherapy versus neoadjuvant chemotherapy alone was generally maintained across the surgery subgroups.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.