The MDT-BRIDGE study is a phase 2, multidisciplinary team–guided investigation of perioperative durvalumab plus neoadjuvant platinum-based chemotherapy in patients with resectable or borderline resectable non-small-cell lung cancer. The study team stated the primary endpoint as the overall resection rate; this endpoint was reported descriptively and the protocol did not include formal hypothesis testing for that measure. Secondary endpoints reported by investigators included event-free survival (EFS), progression-free survival (PFS), pathological complete response (pCR) in the resectable cohort, circulating tumor DNA (ctDNA) clearance between baseline and presurgery/pre-CRT, and safety. The trial registration is NCT05925530.
A total of 142 patients entered neoadjuvant treatment. The cohort composition at baseline was described as 64.8% classified as resectable and 35.2% classified as borderline resectable. The source did not provide granular demographic breakdowns, molecular subgroup distributions, or explicit dosing schedules in the abstract. Investigators reported that multidisciplinary assessments during the neoadjuvant period guided whether patients would proceed to surgery or receive chemoradiotherapy (CRT) followed by consolidation durvalumab if deemed unresectable.
Investigators observed an overall resection rate of 74.6% with a 95% confidence interval of 66.7–81.6. The report emphasised that this population included more than one-third of patients who were borderline resectable at baseline. Among patients who proceeded to surgery, the rate of complete (R0) resection was 96.2% (90.6–99.0). The study team listed pCR as a predefined secondary endpoint for the resectable cohort; the abstract did not report a numeric pCR result.
Following completion of neoadjuvant therapy, 131 patients (92.3%) received either surgery (n = 106) or CRT (n = 25). Of the overall population, 117 patients (82.4%) went on to receive durvalumab as adjuvant (n = 94) or consolidation (n = 23) therapy. The authors noted that the MDT-guided approach facilitated delivery of curative-intent local therapy for the large majority of enrolled patients and allowed subsequent immunotherapy administration in most cases.
The trial report provided safety data specific to the adjuvant or consolidation durvalumab window. During that period, maximum grade 3–4 adverse events occurred in 7.4% of patients who had undergone resection and in 17.4% of patients treated with CRT. Treatment discontinuation due to adverse events during adjuvant or consolidation durvalumab was 8.5% in the resected group and 13.0% in the CRT-treated group. Investigators described these toxicity rates as manageable and consistent with prior durvalumab experience; the abstract did not list specific adverse event types or timing details.
The study implemented multidisciplinary team assessments during the neoadjuvant period to determine candidacy for surgery versus definitive CRT with subsequent consolidation immunotherapy. Investigators reported that this tailored approach was feasible in routine trial conduct and enabled an individualized pathway: patients judged resectable proceeded to surgery, while those assessed as unresectable after neoadjuvant therapy received CRT followed by consolidation durvalumab. The source did not detail the specific MDT decision criteria or the frequency of reassessments.
The authors positioned MDT-BRIDGE within a broader body of evidence that has shifted practice toward neoadjuvant chemoimmunotherapy for early-stage NSCLC. They referenced the AEGEAN trial and other perioperative studies that reported improved pCR and EFS with perioperative anti–PD-L1 or anti–PD-1 agents plus chemotherapy. The MDT-BRIDGE team also noted a persistent clinical problem: across phase 3 perioperative studies roughly 20% of patients deemed resectable at baseline did not proceed to surgery, commonly because of progression, toxicity or clinical decision. A US real-world cohort (REASON) reported a higher non-surgical rate of 34.5% (167 of 484) after neoadjuvant checkpoint inhibition plus chemotherapy.
The study authors and abstract acknowledged several limitations. The primary endpoint was descriptive with no formal hypothesis testing; the source did not provide full statistical plans or detailed subgroup efficacy results in the abstract. Important operational details were not reported in the summary, including specific dosing, adverse event types beyond overall grade 3–4 rates and the explicit MDT criteria used to triage patients. Investigators noted that evidence remains limited about the optimal management pathway for patients initially judged resectable who do not proceed to surgery after neoadjuvant chemoimmunotherapy. The abstract concluded by reporting feasibility, promising early efficacy signals and a safety profile aligned with prior durvalumab experience, and left open the question of how best to refine MDT decision rules and long-term outcomes for these patients.