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AEGEAN

Lung Cancer

AEGEAN

Manufactured by: AstraZeneca
Product name: Imfinzi® (Durvalumab)

About the AEGEAN Trial

The AEGEAN trial is a Phase III, randomized, double-blind study evaluating the efficacy of perioperative durvalumab in patients with resectable stage IIA to IIIB (N2) non-small cell lung cancer (NSCLC). Participants received neoadjuvant durvalumab plus platinum-based chemotherapy followed by surgery, and then adjuvant durvalumab, compared to a control arm receiving placebo plus chemotherapy. The primary endpoint was event-free survival (EFS), with secondary endpoints including pathologic complete response (pCR) and major pathologic response (MPR). Durvalumab significantly improved EFS and pathologic response rates compared to placebo. Additional analyses showed higher rates of circulating tumor DNA (ctDNA) clearance and deeper pathological responses in the durvalumab arm. These results were presented by Dr. Martin Reck at the 2023 ESMO Congress in Madrid. See Dr. Hidehito Horinouchi for more online commentary. 

Table of Contents

Major Presentations and Milestones

AEGEAN Trial design, results, and conclusions

AEGEAN Sentiments and Criticisms

AEGEAN Temporal Sentiment Arc

Professional Resources : Interactive Tweet History, Influence Diagram, Sentiment Table, AI Chatbot

AEGEAN Trial: Major Presentations and Milestones

Primary speakers driving the story

Dr. John Heymach presented the results of AEGEAN at AACR23 with a discussion by Dr. Roy Herbst

Dr. Drew Moghanaki had an interesting perspective on the AEGEAN presentation by Dr. Heymach

Dr. Mark Awad presentation at ASCO23 of KEYNOTE 671, discussing AEGEAN in the context of overlapping trials

Martin Reck, MD, PhD (ESMO23 ; ctDNA analysis highlighted by KOLs): “ctDNA potentially can be a predictive marker, often early.” 

 

Hidehito Horinouchi, MD, PhD (ESMO 2023 session highlights): “AEGEAN: Association of ctDNA clearance and pathologic response … Earlier ctDNA CL was associated with higher likelihood of pCR and MPR.” https://twitter.com/HHorinouchi/status/1716442628106158577

NEJM (journal publication milestone): “Full AEGEAN trial Research Summary.” https://twitter.com/NEJM/status/1722267741644591118

Rami Manochakian, MD (ESMO 2023 + NEJM publication signal boost): “Just published @NEJM in conjunction with presentation @myESMO #ESMO23. ‘Results of #AEGEAN trial of #Perioperative #Durvalumab …’” https://twitter.com/RManochakian/status/1716443585933975700

2024, Oncology Brothers Discussion with Dr. Sandip Patel and Dr. Mara Antonoff regarding FDA Approval based on AEGEAN clinical trial

KOL reactions to the presentation and its significance

AEGEAN Trial design, results, and conclusions

Core design/results (as amplified by KOLs)

Overview amplified by KOLs

KOL deep‑dives on design/results

Treatment landscape context

Subsets and deeper reads

Biomarker/ctDNA threads and mini‑oral details

Translational/MRD takeaways

PRO/QoL and duration pragmatics (KOL questions in practice)

AEGEAN Trial Sentiments from KOLs: standard of care and critical appraisals

Strongly supportive/SoC‑leaning voices

Rami Manochakian, MD (NEJM + ESMO23 alignment; dissemination): https://twitter.com/RManochakian/status/1716443585933975700

Charu Aggarwal, MD, MPH (ctDNA predictive potential; translational enthusiasm): https://twitter.com/CharuAggarwalMD/status/1716442186701508961

Hidehito Horinouchi, MD, PhD (design clarity and ctDNA‑pCR/MPR linkage): https://twitter.com/HHorinouchi/status/1716442628106158577

Critical/contrarian perspectives (design, control arm, real‑world ethics, prevention)

Dr. Ido Wolf: Time Toxicity, Financial Toxicity: https://x.com/IdoWolf5/status/1647910420517122051

Stephen V. Liu, MD (cross‑trial maturity critique): “Notes challenges of comparing studies … EFS curves … widen … plateau … data more reassuring (with KEYNOTE 671) with longer f/u than AEGEAN.” https://twitter.com/StephenVLiu/status/1664989062954987521

Nathan Pennell, MD (strategy ambiguity): “Final results of neoadjuvant ChemoIO vs Neo+adj IO: clear as mud!” 

Dr. Jack West: Cost Concern relative the Checkmate 816

At the AACR23 discussion, Dr Roy Herbst stated that AEGEAN is a new standard of care but not yet the standard of care

Dr. Naidoo shared the specific critique of AEGEAN by Dr. Herbst: 

AEGEAN Temporal Sentiment Arc

AEGEAN Temporal Sentiment Arc (updated with AACR23)

2023 (AACR 2023 primary perioperative readout; AEGEAN enters the algorithm) Primary/KOL tweets:

Mid‑2023 (ASCO 2023 discussant window; cross‑trial comparisons and pragmatics) Primary/KOL tweets:

Late‑2023 (ESMO 2023 ctDNA analyses; NEJM publication; translational lift) Primary/KOL tweets:

2024 (education and comparative EFS framing) Primary/KOL tweets:

2025 (ongoing international reflections; optimization and adoption signals) Primary/KOL tweets:

The arc now clearly starts at AACR 2023 with AEGEAN’s perioperative durvalumab readout and evolves through ASCO 2023 comparisons, ESMO/NEJM translational lift, 2024 practice building, and 2025 refinement. Enthusiasm for perioperative IO is durable; debates have shifted toward how to integrate ctDNA, calibrate duration, and streamline perioperative workflows in routine care.

AEGEAN Professional Resources