A first-line treatment combination of Jemperli (dostarlimab-gxly) and chemotherapy demonstrated better effectiveness in patients with advanced non-small cell lung cancer (NSCLC) versus first-line treatment with Keytruda (pembrolizumab) plus chemotherapy.
Findings, demonstrated by the phase 2 PERLA trial, were presented at the 2024 Society for Immunotherapy of Cancer (SITC) Annual Meeting.
The PERLA trial evaluated 243 patients who were randomly assigned evenly to either the Jemperli plus chemotherapy group (121 patients) or the Keytruda plus chemotherapy group (122 patients). Patients’ cancer was evaluated via clinic visits every three weeks with serial imaging completed at weeks 6 and 12, then at weeks 9 to 48, followed by every 12 weeks thereafter.
In the Jemperli group, the median duration of follow-up was 31.1 months versus 31.9 months in the Keytruda group. The median overall survival (OS) in the Jemperli group was 20.2 months versus 15.9 months in the Keytruda group.
The respective OS rates for the Jemperli and Keytruda groups were 63% versus 58% at 12 months, 51% versus 43% at 18 months, 46% versus 33% at 24 months and 40% versus 27% at 30 months.
The OS results were also related to PD-L1 status. For patients with a PD-L1 tumor proportion score (TPS) of less than 1%, the median OS was 20.8 months in the Jemperli group versus 16.1 months in the Keytruda group. For patients with a PD-L1 TPS of 1% or more, the median OS was 19.4 months versus 15.9 months. Patients with a PD-L1 TPS of 1% to 49% had a median OS of 17.1 months versus 14.5 months. Patients with a PD-L1 TPS of 50% or more had a median OS of not reached versus 17.6. When the median OS is not reached, it means the average amount of patients with a PD-L1 TPS of 50% or more did not experience death by the data collection date.
“The updated OS analysis reaffirms the previous observation that efficacy and safety data were generally comparable between patients with [Jemperli] plus chemotherapy and those treated with [Keytruda] plus chemotherapy,” Dr. Solange Peters noted during the presentation. “The previously observed numerical trend in OS favoring [Jemperli] plus chemotherapy versus [Keytruda] and chemotherapy was maintained.”
Peters is a full professor and chair of the Medical Oncology and Thoracic Malignancies Programme in the Department of Oncology at the University Hospital of Lausanne in Switzerland.
Glossary
Overall survival (OS): time patients live with their cancer, regardless of its status.
PD-L1 status: the amount of PD-L1 (a protein that controls the body’s immune response) in a tumor and its ability to respond to the immunotherapy treatment.
Tumor proportion score (TPS): how much PD-L1 is expressed on tumor cells.
ECOG performance status: how well patients can independently complete their tasks based on a 0 to 4 score. A score of 0 means they are fully independent and a 4 means they cannot complete tasks independently.
A majority of patients between the Jemperli and Keytruda groups were male (70% versus 63%), and the median age was 64 years versus 65years. Brain metastases were present in 18% versus 12% of patients and an ECOG performance status of 1 was noted in each group (69% versus 59%).
Overall, 36% of patients in the Jemperli group and 21% in the Keytruda group are still receiving treatment, while 64% versus 79% have completed therapy. Of note, 61% versus 73% of patients died because of any reason, and 2% versus 6% of patients withdrew from the study.
The safety profile remained consistent with previous results. Any-grade side effects were noted in 98% of patients in the Jemperli group compared with 98% in the Keytruda group. In each arm, 85% versus 81% had treatment-related side effects and 65% versus 66% had side effects that were grade 3 (severe) or worse. Fatal side effects occurred in 12% versus 10% of patients, respectively.
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Reference
“Updated overall survival from PERLA a phase II randomized double-blind trial of dostarlimab + chemotherapy vs pembrolizumab + chemotherapy in metastatic non-squamous non-small cell lung cancer” by Dr. Solange Peters, et al., 2024 SITC Annual Meeting.
