KEY TAKEAWAYS
- The phase II PERLA study compared two PD-1 inhibitors (Dos + CT and Pem + CT) to treat NSCLC, revealing comparable effectiveness.
- The findings suggested that Dos when paired with other treatments, warrants further investigation given its similar effectiveness and acceptable safety profile compared to Pem + CT.
The phase II PERLA study was the first global direct comparison of two programmed death (PD)-1 inhibitors for non-small cell lung cancer (NSCLC), demonstrating comparable effectiveness between dostarlimab (Dos) + chemotherapy (CT) and pembrolizumab (Pem) + CT without discovering any new safety concerns. This study presented the overall response rate (ORR) based on patient and disease features.
The PERLA study analyzed the effectiveness of Dos + CT versus Pem + CT as an initial treatment for patients (pts) with metastatic non-squamous NSCLC who didn’t have targetable cancer-causing genes and had an Eastern Cooperative Oncology Group performance status (ECOG PS) ranging between 0 and 1. Patients were categorized based on their PD-L1 levels and smoking habits and then equally divided to either receive Dos at 500 mg or Pem at 200 mg every three weeks for a maximum of 35 cycles.
Both treatments were combined with up to 35 cycles of 500 mg/m2 pemetrexed and up to 4 cycles of platinum-based chemotherapy (either area under the curve 5 mg/mL/min carboplatin or 75 mg/m2 cisplatin) every three weeks. Disease evaluations occurred at Weeks 6 and 12, followed by every 9 weeks until Week 48, and subsequently every 12 weeks. Based on patient and disease features ORR were exploratory analyses; point estimates and 95% Clopper–Pearson confidence intervals (CIs) were reviewed.
The ORR remained consistent across subgroups, with a numerical preference towards Dos + CT in all categories, except for those with ECOG PS 0, which stood at 46% for both treatments. Within the Dos + CT group, the ORR was consistently 46% regardless of age or ECOG PS. However, patients with ECOG PS 1 who received Pem + CT showcased a lower ORR than those with ECOG PS 0.
The study confirmed that the ORR was relatively consistent across both treatment methods and their respective subgroups. In line with the previously reported results from the PERLA study, which highlighted the similar effectiveness and acceptable safety between the treatments, these findings further advocate for exploring Dos combined with alternative treatments.
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT04581824
Ortega Granados, A.L.O., Lim, S.M., Schenker, M., de Marinis, F., Puig, J.M., Lee, D.H., Arriola, E., Pradera, J. F., O’Donnell, S., Szijgyarto, Z., Cho, L., Ahn, J.S. 44P – Dostarlimab (Dos) or pembrolizumab (Pem) + chemotherapy (CT) in previously untreated metastatic non-squamous non-small cell lung cancer (NSCLC): Patient (Pt) and disease characteristics subgroup analyses from the PERLA trial. Journal of Thoracic Oncology (2023) 18 (4S): S35-S88.
