This clinical trial is focused on studying a type of lung cancer known as Stage I adenocarcinoma non-small cell lung cancer (NSCLC). This study is particularly interested in patients who have a positive result for circulating tumor DNA (ctDNA) or have certain high-risk features after their tumor has been completely removed through surgery. The trial will explore the effectiveness and safety of a new treatment option using a combination of two medications: Datopotamab deruxtecan and Rilvegostomig, which is also known by its code name AZD2936. These medications are given as a solution through a vein, a method known as intravenous infusion.

The purpose of the study is to see if the combination of Datopotamab deruxtecan and Rilvegostomig works better than the standard treatments currently available. Participants in the study will be randomly assigned to receive either the new combination treatment, Rilvegostomig alone, or the standard care, which may include medications like Pemetrexed, Vinorelbine, Carboplatin, Cisplatin, Etoposide, Infliximab, or Mycophenolate mofetil. Some participants may receive a placebo. The study will monitor participants over time to assess how well the treatments work and to check for any side effects.

Throughout the study, researchers will collect information on how long participants remain free of cancer, known as disease-free survival, and overall survival, which is the length of time participants live after starting the study. They will also look at how the treatments affect participants’ physical function and quality of life. Additionally, the study will measure the levels of the medications in the blood and check for any immune reactions to the treatments. The trial aims to provide valuable insights into improving treatment options for patients with this type of lung cancer.