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          An AstraZeneca sign at ESMO in Madrid.
          An AstraZeneca ad at ESMO 2023 in Madrid. Andrew Joseph/STAT

          MADRID — Questions about one of AstraZeneca’s key cancer drug candidates — and the dribs and drabs that have come out about its performance — have been dogging the company for months.

          On Monday, data presented here from a trial of the drug in advanced non-small cell lung cancer provided at least a fuller look. While the results assuaged some of the safety fears that flared when initial information was released over the summer, they only heightened concerns about the drug’s ability to outperform standard chemotherapy — though they perhaps pointed to an opportunity for the drug in a subset of patients.

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          The trial, detailed here in a prime session at the annual meeting of the European Society for Medical Oncology, is testing a therapy called datopotamab deruxtecan, or Dato-DXd, in advanced or metastatic non-small cell lung cancer in patients who already tried at least first-line treatments. Patients were randomized to either receive chemotherapy or Dato-DXd, which AstraZeneca is developing with Daiichi Sankyo.

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