INcorporating pathologic reSponse in patIents with early staGe lung cancer to optimize immunotHerapy in the adjuvanT setting (INSIGHT)

Stage II-IIIB NSCLC (excluding clinical N3 disease).
Complete (R0) resection within 84 days prior to randomization, with appropriate lymph node sampling per NCCN Guidelines.
Acceptable surgical resections: lobectomy, sleeve resection, bi-lobectomy, or pneumonectomy (wedge resection not allowed).
NCCN Guidelines: Minimum of one N1 and three N2 stations sampled or complete lymph node dissection required. Formal ipsilateral mediastinal lymph node dissection required for N2 disease.
Pathologic complete response (pCR) required (no viable tumor in resected specimen or lymph nodes, per local pathology review).
PD-L1 status must be determined (<1%, >=1%, or unknown).
Exclusion criteria: Known EGFR mutations or ALK gene fusion.
Neoadjuvant therapy: Minimum of two cycles of FDA-approved, standard-of-care platinum-based chemotherapy + anti-PD-1/PD-L1 therapy per NCCN guidelines.
No concurrent treatment: No non-protocol chemotherapy, immunotherapy, biologic, or hormonal therapy for NSCLC.
No recent systemic therapy: No chemotherapy, immunotherapy, or investigational drugs within 28 days prior to randomization.
No contraindications: Must not have medical contraindications or severe AEs to anti-PD-1/PD-L1 therapy.
No prior PORT: Participants must not have received post-operative radiation therapy.
No unresolved Grade >= 2 toxicity (except alopecia, vitiligo); Grade >= 2 neuropathy and irreversible toxicity may be allowed at investigator discretion.

Please see Protocol Section 5 for full details