Dr. de Marinis on the PERLA Trial in Metastatic NSCLC

Filippo de Marinis, MD, director, Thoracic Oncology Division, vice director, Lung Cancer Program, European Institute of Oncology, IRCCS, Milan, discusses the goal of the phase 2 PERLA trial (NCT04581824) in metastatic nonsquamous non–small cell lung cancer (NSCLC), as well as significant results from a primary analysis of this study.

The randomized study evaluated the efficacy and safety of PD-1 inhibitors dostarlimab-gxly (Jemperli) plus chemotherapy vs pembrolizumab (Keytruda) plus chemotherapy in the first-line treatment of metastatic nonsquamous NSCLC, de Marinis begins. The patient population consisted of individuals with newly diagnosed, metastatic, nonsquamous NSCLC The trial was designed as a large, global, noninferiority study. Accordingly, its main goal was to show comparable survival outcomes with dostarlimab and chemotherapy rather than a survival advantage over pembrolizumab and chemotherapy, de Marinis notes.

The study’s primary end point was confirmed objective response rate (ORR), with secondary end points of progression-free survival (PFS) and overall survival (OS).

At approximately 6 months median follow-up, the ORR was similar between groups. Dostarlimab plus chemotherapy elicited an ORR of 46%, while treatment with pembrolizumab plus chemotherapy led to an ORR of 37%, de Marinis states. Median PFS was 8.8 months in the dostarlimab treatment arm versus 6.7 months in the pembrolizumab treatment arm. Moreover, an increase in partial response rate was observed with the dostarlimab regimen. These data demonstrate a numerical, but not statistically significant, advantage with dostarlimab plus chemotherapy, de Marinis explains. Dostarlimab also exhibited a treatment-emergent adverse event profile consistent with previous trials of similar regimens. 

These positive results not only confirm the anti-tumor activity of dostarlimab but support the use of both combination regimens in this population.