Durvalumab + Oleclumab (CD73) or Monalizumab (NKG2A) Lowers PFS Hazard ≈40% in Unresectable Stage III NSCLC

Durvalumab, an anti‑PD‑L1 antibody, was paired with oleclumab (anti‑CD73) or monalizumab (anti‑NKG2A) in the open‑label phase 2 COAST trial (NCT03822351) enrolling 189 patients with unresectable stage III NSCLC and no progression after concurrent chemoradiotherapy; 59, 61 and 66 patients received durvalumab+oleclumab, durvalumab+monalizumab, or durvalumab alone, respectively. Confirmed ORR rose to 35.0% and 40.3% versus 23.9% for durvalumab alone (differences not statistically significant), yet progression‑free survival improved with hazard ratios 0.59 and 0.63 and overall‑survival HRs of 0.69 and 0.77 remained nonsignificant after 30 months’ follow‑up. Grade 3+ adverse events were comparable across arms with no new signals; for context, PACIFIC reported median PFS 16.8 mo and ORR 28% for durvalumab consolidation, so adding CD73 or NKG2A blockade appears to deepen disease control without extra toxicity.