Study of Treatment With Sacituzumab and Zimberelimab for Patients With Lung Cancer Confined to the Chest and Previously Operated on Who Were Not Disease-free.

Inclusion Criteria:

• 1. Patients diagnosed of primary non-small cell lung cancer, histologicallyconfirmed.
• 2. Patients should be classified postoperatively in stage IB, IIA, IIB, IIIA or IIIB (N2) according to pathological criteria (pTNM) and according to 8th version of theInternational Association for the Study of Lung Cancer Staging Manual in ThoracicOncology
• 3. Complete surgical resection (R0) of the primary NSCLC is also essential. Surgeonsare strongly advised to dissect or obtain samples of all accessible lymph nodelevels, as established in the European Society of Thoracic Surgeons guide.Consequently, at the end of the surgical intervention it is recommended to haveobtained samples of a minimum of 3 specific mediastinal ganglionic lobe stations (N2), one of which should include station 7, and at least one N1 station
• 4. The surgical intervention may consist of a lobectomy, sleeve resection,bilobectomy or pneumonectomy, as determined by the responsible surgeon based onintraoperative findings. Patients who have had only segmentectomies or wedgeresections are not considered eligible for participation in this study except if R0resection can be confirmed.
• 5. Only patients that do not achieve pathological complete response (pCR) seen inthe surgical piece after neoadjuvant therapy are eligible.
• 6. Preoperative (neoadjuvant) use of platinum-based chemotherapy + immunotherapy (anti PD-1) is mandatory.
• 7. Preoperative, postoperative, or scheduled radiation therapy is not accepted for alater time. Patients with only N2 disease, who have to receive post-operativeadjuvant radiotherapy will not be eligible.
• 8. A minimum of 3 weeks must have elapsed between the surgical interventionperformed for the NSCLC and the randomization. Adjuvant treatment must start betweenthe 3rd and the 10th week from surgery.
• 9. Eastern Cooperative Oncology Group (ECOG) performance status 0-1
• 10. Patients aged ≥ 18 years.
• 11. PDL1 value analysed locally (hospital must be able to provide this value beforerandomization)
• 12. PET-CT and brain CT before randomization to confirm the absence of distantdisease.
• 13. Adequate hematologic and organ function

• 14.All patients are notified of the investigational nature of this study and signeda written in-formed consent in accordance with institutional and nationalguidelines, including the Declaration of Helsinki prior to any trial-relatedintervention.

• 15.For female patients of childbearing potential, agreement (by patient and/orpartner) to use a highly effective form(s) of contraception

• 16. For male patients with female partners of childbearing potential, agreement (bypatient and/or partner) to use a highly effective form(s) of contraception
• 17. Oral contraception should always be combined with an additional contraceptivemethod because of a potential interaction with the study drugs.

• 18.Women who are not postmenopausal or surgically sterile must have a negative serumpregnancy test result within 14 days prior to initiation of study drug.

• 19.Patient capable of proper therapeutic compliance and accessible for correctfollow-up

• 20. Patients with a life expectancy of at least more than 12 weeks

Exclusion Criteria:

• 1. Patients with a history of other malignant diseases, with the exception of thefollowing:

• properly treated non-melanotic skin cancer

• cancer in situ treated with curative intent or other malignancies treated withcurative intent and without signs of disease for a period of> 3 years after theend of the treatment and which, in the opinion of the doctor in charge of theirtreatment, do not present a substantial risk of relapse of the previousmalignant disease.

• 2.T4 patients with invasion of heart, great vessels, carina, trachea, oesophagus orspine

• 3. Patients with ALK translocation, STK11 o KEAP1 known mutations before inclusionin this trial.
• 4. Patients with adenocarcinoma NSCLC must be tested for the common EGFR mutationsbefore inclusion. Patients with any known EGFR mutation cannot be enrolled in thestudy.
• 5. Patients with a combination of microcytic and non-small cell lung cancer, acarcinoid lung tumor or large cell neuroendocrine carcinoma
• 6. Have active chronic inflammatory bowel disease (ulcerative colitis, Crohn'sdisease) or GI perforation within 6 months of randomization.
• 7. Patients that received live attenuated vaccines within 30 days prior torandomization
• 8. History of a primary immunodeficiency, history of organ allogeneictransplantation, use of immunosuppressive drugs within 28 days before randomizationor previous history of toxicity of severe immune mechanism (grade 3 or 4) with otherimmunological treatments
• 9. Patients with active or uncontrolled infections or with serious medicalconditions or disorders that may not allow patient management as established in theprotocol.
• 10. Patients who have suffered untreated and / or uncontrolled cardiovasculardisorders and / or who have symptomatic cardiac dysfunction
• 11. Pregnant or breastfeeding women
• 12. Patients in whom R0 resection cannot be confirmed.
• 13. Patients with an active, known or suspected autoimmune disease. Participantswith type I diabetes mellitus, hypothyroidism only requiring hormone replacement,skin disorders not requiring systemic treatment, or conditions not expected to recurin the absence of an external trigger are permitted to enroll.

• 14.Patients with a condition requiring systemic treatment with eithercorticosteroids or other immunosuppressive medications within 14 days ofrandomization. Inhaled or topical steroids, and adrenal replacement steroid doses > 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmunedisease.

• 15. Have active hepatitis B virus (HBV) or hepatitis C virus (HCV). In patients witha history of HBV or HCV, patients with detectable viral loads will be excluded.
• 16. History of allergy or hypersensitivity to any of the study drug components
• 17. Pleural or pericardial effusion, both will be considered indicative ofmetastatic disease unless proven otherwise. Patients with pleural effusion notvisible on chest-X-ray or too small to perform diagnostic puncture safely may beincluded.
• 18. Have known history of HIV-1 or 2 with detectable viral load OR takingmedications that may interfere with SN-38 metabolism.

• 19.Severe infections within 4 weeks prior to be included in the study, including butnot limited to hospitalization for complications of infection, bacteraemia, orsevere pneumonia.

• 20.Patients with medical, mental, neurological or psychological condition which inthe opinion of the investigator would not permit the patient to understand thepatient information sheet or comply with study procedures.

• 21. Clinically severe pulmonary compromise resulting from intercurrent pulmonaryillnesses including, but not limited to, any underlying pulmonary disorder; anyautoimmune, connective tissue, or inflammatory disorders with pulmonary involvement;or prior pneumonectomy.
• 22. Treatment with systemic immunosuppressive medications

• 23.Patients with uncontrolled comorbidities that may affect the clinical trialcompliance.

• 24.Sexually active men and women of childbearing potential who are not willing touse an effective contraceptive method during the study.