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Rilvegostomig

Phase 3

Biliary Tract Cancer | Small molecule | Oncology |AstraZeneca PLC|Last Updated: Sep 3, 2026

Target and mechanism

ModalitySmall molecule

Also known as IV Rilvegostomig

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials2
Total Enrollment1,860

FDA Designations

No designations recorded

Clinical trial landscape

Rilvegostomig · 12 trials · 11 indications

Phase 3 7Phase 2 2Phase 1 2Early Phase 1 1
NCT07221253A Study of Rilvegostomig or Durvalumab Plus Chemotherapy for First-Line Treatment of Biliary Tract Cancer (ARTEMIDE-Biliary02)Biliary Tract Cancer
RECRUITING1,100 Analytics
NCT06868277A Global Phase III Study of Rilvegostomig or Pembrolizumab Monotherapy for First-Line Treatment of PD-L1-high Metastatic Non-small Cell Lung CancerCarcinoma, Non-Small Cell Lung
RECRUITING830 Analytics
NCT06989112DESTINY-Endometrial01: A Phase III Study of Trastuzumab Deruxtecan Plus Rilvegostomig or Pembrolizumab as First-Line Treatment of HER2-Expressing (IHC 3+/2+), Mismatch Repair Proficient (pMMR) Endometrial CancerEndometrial Cancer
RECRUITING600 Analytics
NCT06764875A Phase Ⅲ Study of Rilvegostomig in Combination With Fluoropyrimidine and Trastuzumab Deruxtecan as the First-line Treatment for HER2-positive Gastric CancerHER2-positive Gastric Cancer
RECRUITING840 Analytics
NCT06627647A Global Phase III Study of Rilvegostomig or Pembrolizumab Plus Chemotherapy for First-Line Treatment of Locally Advanced or Metastatic Non-Squamous NSCLCNon-squamous Non-small Cell Lung Cancer
RECRUITING1,160 Analytics
NCT06692738A Global Phase III Study of Rilvegostomig or Pembrolizumab Plus Chemotherapy for First-Line Treatment of Locally Advanced or Metastatic Squamous Non-small Cell Lung Cancer (NSCLC)Non-small Cell Lung Cancer
RECRUITING1,160 Analytics
NCT06109779Rilvegostomig + Chemotherapy as Adjuvant Therapy for Biliary Tract Cancer After Resection (ARTEMIDE-Biliary01)Biliary Tract Cancer
ACTIVE NOT_RECRUITING760 Analytics
PHASE3RECRUITING
A Study of Rilvegostomig or Durvalumab Plus Chemotherapy for First-Line Treatment of Biliary Tract Cancer (ARTEMIDE-Biliary02)
Biliary Tract CancerUnlock trial analytics
PHASE3RECRUITING
A Global Phase III Study of Rilvegostomig or Pembrolizumab Monotherapy for First-Line Treatment of PD-L1-high Metastatic Non-small Cell Lung Cancer
Carcinoma, Non-Small Cell LungUnlock trial analytics
PHASE3RECRUITING
DESTINY-Endometrial01: A Phase III Study of Trastuzumab Deruxtecan Plus Rilvegostomig or Pembrolizumab as First-Line Treatment of HER2-Expressing (IHC 3+/2+), Mismatch Repair Proficient (pMMR) Endometrial Cancer
Endometrial CancerUnlock trial analytics
PHASE3RECRUITING
A Phase Ⅲ Study of Rilvegostomig in Combination With Fluoropyrimidine and Trastuzumab Deruxtecan as the First-line Treatment for HER2-positive Gastric Cancer
HER2-positive Gastric CancerUnlock trial analytics
PHASE3RECRUITING
A Global Phase III Study of Rilvegostomig or Pembrolizumab Plus Chemotherapy for First-Line Treatment of Locally Advanced or Metastatic Non-Squamous NSCLC
Non-squamous Non-small Cell Lung CancerUnlock trial analytics
PHASE3RECRUITING
A Global Phase III Study of Rilvegostomig or Pembrolizumab Plus Chemotherapy for First-Line Treatment of Locally Advanced or Metastatic Squamous Non-small Cell Lung Cancer (NSCLC)
Non-small Cell Lung CancerUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Rilvegostomig + Chemotherapy as Adjuvant Therapy for Biliary Tract Cancer After Resection (ARTEMIDE-Biliary01)
Biliary Tract CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

Overall Survival (OS) in the PDL1 ≥ 1% population
approximately 4 years

Overall Survival is defined as time from randomization until the date of death due to any cause.

Overall Survival (OS)
Up to approximately 5 years

OS is defined as the time from randomization until the date of death due to any cause.

Progression-Free Survival (PFS)
Up to approximately 5 years

PFS is defined as the time from randomization until radiological progression per RECIST 1.1 or death due to any cause (in the absence of progression).

Progression-free survival (PFS), as assessed by BICR
Until progression or death due to any cause (assessed up to approximately 45 months).

Defined as time from randomization until progression per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR), or death due to any cause.

Progression free survival (PFS)
Up to approximately 6 years

PFS is defined as time from randomization until progression per RECIST v1.1, or death due to any cause.

Recurrence free survival (RFS) for Arm A vs. Arm B
Approximately 5 years

Recurrence-free survival (RFS) is defined as the time from randomization until the date of radiological recurrence guided by RECIST 1.1 or death due to any cause, whichever occurs first.

Number of participants with adverse events (AE) and serious adverse events (SAE)
Through study completion, an average of 3 years

To assess the safety and tolerability

Objective response rate (ORR)
Through study completion, an average of 3 years

ORR is defined as the proportion of participants who have a confirmed CR (complete response) or confirmed PR (partial response) per RECIST 1.1

ORR (per RECIST 1.1 as assessed by Investigator)
Through substudy completion, an average of 2 years

the proportion of participants who have a confirmed complete response or confirmed partial response, as determined by the Investigator at local site per RECIST 1.1.

PFS6 (per RECIST 1.1 as assessed by Investigator)
Through substudy completion, an average of 2 years

the proportion of participants alive and progression-free at 6 months.

Area under the Concentration-time Curve During One Dosing Interval (AUCtau)
From Day 1 up to end of Cycle 2 in Part 1 and end of Cycle 1 in Part 2 (each cycle will be of 3 weeks)

Bioavailability based on AUCtau at first SC dose will be determined.

Part A and Part B: Number of participants with adverse events (AEs) and serious adverse events (SAEs)
Approximately 46 months

To assess the safety and tolerability and determine RP2D of the combination of novel anti-cancer agents.

Part A: Number of partcipants with dose limiting toxicity (DLT)
Approximately 46 months

To assess the safety and tolerability and determine RP2D of the combination of novel anti-cancer agents.

Part B: Objective response (OR)
Approximately 46 months

The OR is defined as a best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR).

Evaluation of signature scores using Gene Set Variability Analysis within regions injected with microdoses of rilvegostomig, volrustomig, sabestomig, AZD9592, or pembrolizumab as single agents or as AZD9592 drug combinations with the evaluated biologics
1 to 3 days after microdose injection

The localized activity of injected microdoses will be analyzed using the NanoString GeoMx Digital Spatial Profiler (DSP) and the GeoMx Cancer Transcriptome Atlas to comprehensively profile over 1800 genes simultaneously with spatial resolution to describe tumor biology, the TME, and the immune response signatures of each drug at an injection site. DSP outcomes may be validated via IHC, immunofluorescence, or ISH technique.

Secondary Endpoints

Overall Survival in the intent to treat (ITT) population
approximately 4 years
Progression Free Survival (PFS) in the PDL1 ≥ 1% population
approximately 4 years
Progression Free Survival (PFS) in the intent to treat (ITT) population
approximately 4 years
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Control ArmACTIVE_COMPARATORDurvalumab IV infusion + chemotherapy combination (Gemcitabine/Cisplatin)
Experimental ArmEXPERIMENTALRilvegostomig IV infusion + chemotherapy combination (Gemcitabine/Cisplatin)
Arm AEXPERIMENTALDrug: rilvegostomig
Arm BACTIVE_COMPARATORDrug: Pembrolizumab
Arm A: T-DXd + RilvegostomigEXPERIMENTALT-DXd IV Q3W plus rilvegostomig IV Q3W. Treatment will continue until objective disease progression according to RECIST v1.1 as assessed by the Investigator and confirmed by BICR or until other discontinuation criteria is met, whichever occurs first.
Arm B: T-DXd + PembrolizumabEXPERIMENTALT-DXd IV Q3W plus pembrolizumab IV Q3W. Treatment will continue until objective disease progression according to RECIST v1.1 as assessed by the Investigator and confirmed by BICR or until other discontinuation criteria is met, whichever occurs first.
Arm C: Carboplatin + Paclitaxel + PembrolizumabACTIVE_COMPARATORCarboplatin, paclitaxel and pembrolizumab administered Q3W for 6 cycles, followed by maintenance with pembrolizumab IV Q6W for 14 cycles. Treatment with pembrolizumab will continue for up to 20 total cycles (approximately 24 months, accounting for combination and maintenance phases) or until other discontinuation criteria is met, whichever occurs first. At the discretion of the investigator, participants may continue to receive carboplatin, paclitaxel and pembrolizumab Q3W for up to 10 cycles. Docetaxel can be used as an alternative to paclitaxel for participants who had a hypersensitivity reaction to paclitaxel with a failed rechallenge (or not amenable to rechallenge), according to the investigator's clinical judgment.
Arm CACTIVE_COMPARATORRilvegostomig + Trastuzumab + FP (5-FU plus cisplatin) or CAPOX (capecitabine plus oxaliplatin)
Sub-study 1, investigate rilvegostomig± ramucirumab in 1L non-AGA NSCLC with PD-L1 ≥50%EXPERIMENTALParticipants will receive rilvegostomig ± ramucirumab until RECIST 1.1-defined radiological progression, unacceptable toxicity, withdrawal of consent, or other discontinuation criterion
Sub-study 2, investigate rilvegostomig + ramucirumab in 1L non-AGA NSCLC with PD-L1 1-49%EXPERIMENTALParticipants will receive rilvegostomig + ramucirumab until RECIST 1.1-defined radiological progression, unacceptable toxicity, withdrawal of consent, or other discontinuation criterion
Sub-study 3, investigate Dato-DXd + ramucirumab ± rilvegostomig in 2/3L AGA+ NSCLCEXPERIMENTALParticipants will receive Dato-DXd + ramucirumab ± rilvegostomig until RECIST 1.1-defined radiological progression, unacceptable toxicity, withdrawal of consent, or other discontinuation criterion
Substudy 1EXPERIMENTALVolrustomig plus XELOX (oxaliplatin and capecitabine) or FOLFOX (oxaliplatin and 5-FU/CF)
Substudy 2EXPERIMENTALRilvegostomig plus XELOX (oxaliplatin and capecitabine) or FOLFOX (oxaliplatin and 5-FU/CF)
Substudy 3EXPERIMENTALAZD0901 plus volrustomig and 5-fluorouracil or capecitabine
Substudy 4, Cohort 4a1EXPERIMENTALSonesitatug vedotin (AZD0901) plus rilvegostomig and 5-fluorouracil or capecitabine
Substudy 4, Cohort 4a2EXPERIMENTALSonesitatug vedotin (AZD0901) plus rilvegostomig and 5-fluorouracil
Substudy 4, Cohort 4bEXPERIMENTALSonesitatug vedotin (AZD0901) plus capecitabine
Part 1 (dose finding): Cohort A - SC Rilvegostomig Dose Level 1 (DL1) and rHuEXPERIMENTALParticipants will receive IV rilvegostomig (Dose X) as their first dose of study treatment, followed by subsequent treatments with recombinant human hyaluronidase (rHu) and SC rilvegostomig (DL1) at predefined intervals.
Part 1 (dose finding): Cohort B - SC Rilvegostomig DL2 and rHuEXPERIMENTALParticipants will receive IV rilvegostomig (Dose X) as their first dose of study treatment, followed by subsequent treatments with rHu and SC rilvegostomig (DL2) at predefined intervals.
Part 2 (dose confirmation): SC Rilvegostomig and rHuEXPERIMENTALParticipants will receive SC rilvegostomig and rHu.
Sub study 2 Part A: Safety run-inEXPERIMENTALParticipants with squamous and non-squamous NSCLC will receive combination therapy of rilvegostomig, ramucirumab, and platinum-based chemotherapy to assess the safety and tolerability of this regimen.
Sub study 2 Part B: Dose expansionEXPERIMENTALParticipants will be randomised 1:1 into one of 2 treatment arms (rilvegostomig + chemotherapy + ramucirumab OR rilvegostomig + chemotherapy) in non-squamous histology cohorts and into a single arm (rilvegostomig + chemotherapy+ ramucirumab) in squamous histology cohorts.
Rilvegostomig, Volrustomig, Sabestomig, AZD9592, PembrolizumabEXPERIMENTALHNSCC patients presenting with a surface accessible lesion who are scheduled for tumor and/or regional node dissection as part of their standard treatment will be injected one to three days prior to surgery using the CIVO device. The planned injection scheme includes: vehicle control and microdoses of rilvegostomig, volrustomig, sabestomig, AZD9592, and pembrolizumab as single agents and AZD9592 drug combinations with the evaluated biologics.

Interventions

NameTypeDescription
RilvegostomigDRUGRilvegostomig IV (intravenous) Q3W
DurvalumabDRUGDurvalumab 1500mg IV (intravenous) Q3W for up to 8 cycles (21days). Then Q4W.
Gemcitabine/CisplatinDRUGGemcitabine/Cisplatin IV (Intravenous) 1000 mg/m2 plus cisplatin 25 mg/m2 on Day 1 and Day 8 of each 21-day cycle
PembrolizumabBIOLOGICALAdministered intravenously (IV) on Day 1 of each 21-day cycle
Trastuzumab deruxtecanDRUGExperimental therapy by intravenous infusion
CarboplatinDRUGStandard of Care (SoC) chemotherapy by intravenous infusion
PaclitaxelDRUGStandard of Care (SoC) chemotherapy by intravenous infusion
DocetaxelDRUGStandard of Care (SoC) chemotherapy by intravenous infusion
TrastuzumabDRUGQ3W, intravenous infusion
5-fluorouracilDRUGQ3W, intravenous infusion
CapecitabineDRUGBID, oral administration
CisplatinDRUGQ3W, intravenous infusion
OxaliplatinDRUGQ3W, intravenous infusion
PemetrexedDRUGAdministered as one intravenously (IV) on Day 1 of each 21-day cycle
Nab-paclitaxelDRUGAdministered intravenously (IV) on Days 1, 8, and 15 of each 21-day cycle up to 4 cycles
PlaceboDRUGPlacebo IV (intravenous) Q3W
S-1 [Tegafur/Oteracil/gimeracil]DRUGS-1 \[Tegafur/Oteracil/gimeracil\] (Oral) BSA (body surface area)-based (40, 50, or 60 mg) BID for 4 weeks on 2 weeks off in 42-day cycles
RamucirumabDRUGRamucirumab will be administered as IV infusion.
Dato-DXdDRUGDato-DXd will be administered as IV infusion.
VolrustomigDRUGan anti PD-1 and anti CTLA-4 bispecific antibody; IV infusion
FOLFOXDRUG5-fluorouracil oxaliplatin, leucovorin (levoleucovorin when locally preferred and available)
XELOXDRUGcapecitabine and oxaliplatin
AZD0901DRUGan anti Claudin18.2 ADC; IV infusion
IV RilvegostomigDRUGRilvegostomig administered IV.
Recombinant Human Hyaluronidase (rHu)DRUGrHu administered subcutaneously.
SC RilvegostomigDRUGRilvegostomig administered subcutaneously.
SC rilvegostomig + rHuDRUGSC rilvegostomig + rHu administered subcutaneously.
SabestomigBIOLOGICALIntratumoral microdose injection by the CIVO device.
AZD9592BIOLOGICALIntratumoral microdose injection by the CIVO device.
AZD9592 + RilvegostomigCOMBINATION_PRODUCTIntratumoral microdose injection by the CIVO device.
AZD9592 + VolrustomigCOMBINATION_PRODUCTIntratumoral microdose injection by the CIVO device.
AZD9592 + SabestomigCOMBINATION_PRODUCTIntratumoral microdose injection by the CIVO device.
AZD9592 + PembrolizumabCOMBINATION_PRODUCTIntratumoral microdose injection by the CIVO device.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites177

Key inclusion Criteria: * Histologically confirmed adenocarcinoma of the biliary tract, including intra-hepatic or extra-hepatic cholangiocarcinoma (CCA) and gallbladder carcinoma (GBC). * Unresectable locally advanced or metastatic BTC, previously untreated in the advanced disease setting * Known ...

Countries:United StatesAustraliaBelgiumBrazilCanadaChinaFranceGermanyIndiaItalyJapanNetherlandsPolandSouth KoreaSpainTaiwanThailandTurkey (Türkiye)United KingdomArgentinaBulgariaChileColombiaCosta RicaGeorgiaGreeceIrelandIsraelMalaysiaPortugalRomaniaSwitzerlandAustriaDenmarkFinlandHungaryNorwaySwedenHong KongPeruPuerto RicoVietnamSingaporeMoldovaSerbia
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Recent Changes (Last 90 Days)

LOWSep 3, 2026NCT06989112lastUpdatePostDate: changed
LOWSep 3, 2026NCT06989112lastUpdatePostDate: changed
LOWSep 1, 2026NCT07161414lastUpdatePostDate: changed
LOWSep 1, 2026NCT07161414lastUpdatePostDate: changed
LOWAug 21, 2026NCT07221253lastUpdatePostDate: changed
LOWAug 21, 2026NCT07221253lastUpdatePostDate: changed
LOWAug 14, 2026NCT06627647lastUpdatePostDate: changed
LOWAug 14, 2026NCT06692738lastUpdatePostDate: changed
LOWAug 14, 2026NCT06627647lastUpdatePostDate: changed
LOWAug 14, 2026NCT06692738lastUpdatePostDate: changed
LOWAug 14, 2026NCT06692738lastUpdatePostDate: changed
LOWAug 11, 2026NCT07161414lastUpdatePostDate: changed
LOWAug 11, 2026NCT06989112lastUpdatePostDate: changed
LOWAug 11, 2026NCT07161414lastUpdatePostDate: changed
LOWAug 11, 2026NCT06989112lastUpdatePostDate: changed
LOWAug 11, 2026NCT07161414lastUpdatePostDate: changed
LOWAug 3, 2026NCT06868277lastUpdatePostDate: changed
LOWAug 3, 2026NCT06868277lastUpdatePostDate: changed
LOWJul 21, 2026NCT06996782lastUpdatePostDate: changed
LOWJul 20, 2026NCT07221253lastUpdatePostDate: changed

Frequently asked questions about Rilvegostomig

What is Rilvegostomig used for?

Rilvegostomig is an investigational oncology drug being studied for multiple cancer types, including Non-Small Cell Lung Cancer, Endometrial Cancer, Non-squamous Non-small Cell Lung Cancer, Advanced or Metastatic Non-small Cell Lung Cancer, Head and Neck Squamous Cell Carcinoma, and Gastric Cancer. It is currently in clinical development and is not yet approved.

Who makes Rilvegostomig?

Rilvegostomig is being developed by AstraZeneca PLC, a biopharmaceutical company traded on the stock exchange under the ticker symbol AZN. The company is conducting clinical trials to evaluate the drug's safety and efficacy in various oncology indications.

What phase is Rilvegostomig in?

Rilvegostomig is in Phase 1 clinical development. While some of its trials are in Phase 2 and Phase 3, the overall development program is led by an active Phase 1 study. The drug is investigational and has not received regulatory approval.

What clinical trials is Rilvegostomig in?

Rilvegostomig is being studied in several recruiting trials. NCT05702229 is a Phase 2 study in gastric cancer. NCT06627647 is a Phase 3 study in non-squamous non-small cell lung cancer. NCT06868277 is a Phase 3 study in PD-L1-high metastatic non-small cell lung cancer. NCT07161414 is a Phase 1 pharmacokinetic study in advanced solid tumors.

Is Rilvegostomig the same as IV Rilvegostomig?

Yes, Rilvegostomig is also known as IV Rilvegostomig. The drug is being studied in both intravenous and subcutaneous formulations, with a Phase 1 trial evaluating the subcutaneous version. Both names refer to the same investigational oncology drug.

What is Rilvegostomig being studied for in gastric cancer?

Rilvegostomig is being studied in a Phase 2 clinical trial (NCT05702229) for participants with locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma. This trial is recruiting patients in multiple countries, including the United States, China, Japan, and South Korea.