A trial to learn how well Dato-DXd and rilvegostomig work and how safe they are in participants with stage I adenocarcinoma non-small cell lung cancer (NSCLC) after complete removal through surgery

Prior treatment

• Active or prior documented autoimmune or inflammatory disorders (with exceptions)

Other illness

• History of non-infectious ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at screening
• History of another primary malignancy within 3 years (with exceptions)
• Any evidence of severe or uncontrolled systemic diseases, including but not limited to bleeding diseases, active infection and cardiac disease
• Active infection with tuberculosis, hepatitis A, B or C virus, or known HIV infection that is not well controlled
• History of active primary immunodeficiency
• Clinically significant corneal disease

Lab values

• Sensitizing EGFR mutation and/or ALK alteration

Other

• Significant pulmonary function compromise

• Histologically documented treatment-naive Stage I (T < 4 cm, AJCC 8th ed) adenocarcinoma NSCLC
• Complete surgical resection (R0) of the primary NSCLC
• Unequivocal no evidence of disease at post-surgical baseline scan
• Pre-surgical ctDNA-positive result (Stage IA or IB) OR presence of at least one high-risk pathological feature (visceral pleural invasion (VPI), lymphovascular invasion (LVI), high-grade histology) (Stage IB only)
• ECOG of 0 or 1, life expectancy of > 6 months and complete recovery after surgery
• Adequate bone marrow reserve and organ function