SKYSCRAPER-03: a phase III study of tiragolumab plus atezolizumab versus durvalumab in locally advanced, unresectable, stage III NSCLC after platinum-based concurrent chemoradiation.
H A Wakelee, M-J Ahn, J Bradley et al.
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In 30 seconds
SKYSCRAPER-03 was a phase III, open-label, randomized trial comparing consolidation tiragolumab plus atezolizumab with durvalumab after platinum-based concurrent chemoradiation in patients with locally advanced, unresectable stage III NSCLC. Among PD-L1-positive patients, median progression-free survival was 19.4 months with the combination and 16.6 months with durvalumab, but the difference was not significant (HR 0.96, 95% CI 0.75-1.23, P = 0.76). Overall survival was also similar, and the primary endpoint was not met; the combination offered no additional benefit over durvalumab.
Key findings
- In PD-L1-positive patients, median PFS was 19.4 months versus 16.6 months (HR 0.96, 95% CI 0.75-1.23, P = 0.76).
- In the PD-L1 all-comers population, median PFS was 14.2 versus 13.8 months (HR 1.00, 95% CI 0.84-1.19).
- Median OS in PD-L1 all-comers was 45.6 versus 45.8 months (HR 0.98, 95% CI 0.80-1.20).
- The combination was tolerated, with no new or unexpected safety findings.
Why it matters
The trial directly compared an added TIGIT-targeting agent plus atezolizumab with durvalumab as consolidation after chemoradiation. Despite numerically longer median PFS in the PD-L1-positive group, the primary endpoint was not met and survival outcomes were similar. These results help clarify that the tested combination did not demonstrate additional benefit over the comparator in this population.
What to keep in mind
The abstract reports a median follow-up of 33.0 months; longer follow-up may further characterize outcomes, particularly where median OS was not estimable.