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NCT04581824

Efficacy Comparison of Dostarlimab Plus Chemotherapy Versus Pembrolizumab Plus Chemotherapy in Participants With Metastatic Non-squamous Non-small Cell Lung Cancer (NSCLC)

Terminated Phase 2 Results posted Last updated 8 August 2025
What this trial tests

Phase 2 trial testing Dostarlimab in Lung Cancer, Non-Small Cell in 243 participants. Terminated before completion.

Timeline
19 November 2020
Primary endpoint
4 August 2022
10 September 2024

Quick facts

Lead sponsorGlaxoSmithKline
PhasePhase 2
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment243
Start date19 November 2020
Primary completion4 August 2022
Estimated completion10 September 2024
Sites58 locations across France, Italy, Chile, Taiwan, Germany, Poland, South Korea, Argentina

Drugs / interventions tested

Conditions studied

Sponsor

GlaxoSmithKline — full company profile →

Who can join

18 and older, any sex, with Lung Cancer, Non-Small Cell. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Overall Survival (OS) Secondary · Up to approximately 46 months

OS was defined as the time from the date of randomization to the date of death by any cause.

GroupValue95% CI
Dostarlimab + Chemotherapy20.214.5 – 27.3
Pembrolizumab + Chemotherapy15.911.6 – 19.3
Progression-free Survival (PFS) Secondary · Up to approximately 46 months

PFS was defined as the time from the date of randomization to the date of disease progression (PD) or death by any cause, whichever occurs first. PFS was evaluated using Response Evaluation Criteria in Solid Tumors Criteria (RECIST) version 1.1 based on Investigator assessment. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start).

GroupValue95% CI
Dostarlimab + Chemotherapy8.86.9 – 11.0
Pembrolizumab + Chemotherapy6.84.9 – 7.1
Number of Participants With Treatment-emergent Adverse Event (TEAEs), TEAEs Leading to Death and TEAEs Leading to Treatment Discontinuation Secondary · Up to 46 months

AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study treatment, whether or not considered related to the study treatment. A TEAE is an event that emerges during treatment having been absent pretreatment or worsens relative to the pretreatment state. Number of participants with TEAEs, TEAEs leading to death, and TEAEs leading to treatment discontinuation are presented. AEs were coded using the Medical Dictionary for Regulatory Affairs (MedDRA dictionary).

TEAEs
GroupValue95% CI
Dostarlimab + Chemotherapy119
Pembrolizumab + Chemotherapy119
TEAEs leading to death
GroupValue95% CI
Dostarlimab + Chemotherapy17
Pembrolizumab + Chemotherapy12
TEAEs leading to treatment discontinuation
GroupValue95% CI
Dostarlimab + Chemotherapy35
Pembrolizumab + Chemotherapy46
Number of Participants With Treatment Emergent Immune-related Adverse Event (irAE) Secondary · Up to 46 months

The irAEs are events which are severe or fatal and can occur in participants treated with monoclonal antibodies directed against immune checkpoints, including pembrolizumab and dostarlimab. While irAEs (eg, diarrhea/colitis, pneumonitis, nephritis, hypophysitis, adrenalitis, thyroiditis, severe skin reactions, uveitis, myocarditis, and hepatotoxicity) usually occur during treatment, symptoms can also manifest after discontinuation of treatment. AEs were coded using the MedDRA dictionary.

GroupValue95% CI
Dostarlimab + Chemotherapy38
Pembrolizumab + Chemotherapy47
Number of Participants With Serious AEs Secondary · Up to approximately 46 months

An SAE is any untoward medical occurrence that, at any dose results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly/birth defect or is an important medical event that may jeopardize the participant or may require medical or surgical intervention to prevent one of the above outcomes. SAEs are subset of AEs. AEs were coded using the MedDRA dictionary.

GroupValue95% CI
Dostarlimab + Chemotherapy51
Pembrolizumab + Chemotherapy61
Number of Participants With Worst Case Clinical Chemistry Results Relative to Normal Range Post-Baseline Relative to Baseline Secondary · Up to approximately 46 months

Normal ranges were 30 to 110 units per liter (U/L) (Amylase); 4. 5 to 5. 6 milligram/deciliters (mg/dL) (Calcium); 96 to 100 milliequivalents (mEq)/ L (Chloride); 2. 5 to 4.5 mg/dL (Phosphate); 6 to 8.3 grams/L (protein); 6 to 24 millimoles/L (Urea) and 7 to 20 mg/dL (Urea nitrogen). Participants were counted in worst case category that their value changes to low, normal or no change \[NC\] or high), unless there is NC in their category. Participants whose laboratory value category was unchanged (e.g. High to High) or whose value became normal, were recorded in "To Normal or No Change" categor

Amylase, To Low
GroupValue95% CI
Dostarlimab + Chemotherapy8
Pembrolizumab + Chemotherapy11
Amylase, To Normal or No Change
GroupValue95% CI
Dostarlimab + Chemotherapy76
Pembrolizumab + Chemotherapy76
Amylase, To High
GroupValue95% CI
Dostarlimab + Chemotherapy34
Pembrolizumab + Chemotherapy30
Calcium, To Low
GroupValue95% CI
Dostarlimab + Chemotherapy42
Pembrolizumab + Chemotherapy39
Calcium, To Normal or No Change
GroupValue95% CI
Dostarlimab + Chemotherapy60
Pembrolizumab + Chemotherapy65
Calcium, To High
GroupValue95% CI
Dostarlimab + Chemotherapy25
Pembrolizumab + Chemotherapy16
Chloride, To Low
GroupValue95% CI
Dostarlimab + Chemotherapy34
Pembrolizumab + Chemotherapy26
Chloride, To Normal or No Change
GroupValue95% CI
Dostarlimab + Chemotherapy65
Pembrolizumab + Chemotherapy69
Number of Participants With Worst Case Hematology Results Relative to Normal Range Post-Baseline Relative to Baseline Secondary · Up to approximately 46 months

Normal ranges were 0.01 to 0.3\*10\^9 cells/L (basophils); 41 to 50 percentage of red blood cells (RBC) in blood (hematocrit); 80-100 femtoliters (fl) (erythrocytes \[referred as Ery\] mean corpuscular volume (EMCV)); 2 to 8 percentage of WBC (monocytes); and Women: 4.2 to 5.4 million RBC/ microliter (mcL) of blood and Men: 4.7 to 6.1 million RBC/ mcL (erythrocytes). Participants were counted in worst case category that their value changes to low, normal or no change \[NC\] or high), unless there is NC in their category. Participants whose laboratory value category was unchanged (e.g. High to

Basophils, To Low
GroupValue95% CI
Dostarlimab + Chemotherapy12
Pembrolizumab + Chemotherapy9
Basophils, To Normal or No Change
GroupValue95% CI
Dostarlimab + Chemotherapy72
Pembrolizumab + Chemotherapy75
Basophils, To High
GroupValue95% CI
Dostarlimab + Chemotherapy19
Pembrolizumab + Chemotherapy19
Hematocrit, To Low
GroupValue95% CI
Dostarlimab + Chemotherapy73
Pembrolizumab + Chemotherapy64
Hematocrit, To Normal or No Change
GroupValue95% CI
Dostarlimab + Chemotherapy43
Pembrolizumab + Chemotherapy50
Hematocrit, To High
GroupValue95% CI
Dostarlimab + Chemotherapy3
Pembrolizumab + Chemotherapy1
EMCV, To Low
GroupValue95% CI
Dostarlimab + Chemotherapy6
Pembrolizumab + Chemotherapy11
EMCV, To Normal or No Change
GroupValue95% CI
Dostarlimab + Chemotherapy59
Pembrolizumab + Chemotherapy54
Number of Participants With Worst Case Urinalysis Results Post-Baseline Relative to Baseline Secondary · Up to approximately 46 months

Urine samples were collected to assess urine Bilirubin, glucose, ketones, Leukocyte Esterase, Nitrite, occult blood and Protein using dipstick method. The dipstick test gave results in a semi-quantitative manner, and results for urinalysis parameters were recorded as No Change/Decreased, Increase to TRACE, Increase to +, Increase to ++, Increase to +++ and Increase to ++++. Baseline (Day 1) was defined as the most recent, non-missing value prior to or on the first study treatment dose date.

Bilirubin, No Change/Decreased
GroupValue95% CI
Dostarlimab + Chemotherapy86
Pembrolizumab + Chemotherapy66
Bilirubin, Increase to TRACE
GroupValue95% CI
Dostarlimab + Chemotherapy0
Pembrolizumab + Chemotherapy0
Bilirubin, Increase to +
GroupValue95% CI
Dostarlimab + Chemotherapy4
Pembrolizumab + Chemotherapy3
Bilirubin, Increase to ++
GroupValue95% CI
Dostarlimab + Chemotherapy0
Pembrolizumab + Chemotherapy0
Bilirubin, Increase to +++
GroupValue95% CI
Dostarlimab + Chemotherapy0
Pembrolizumab + Chemotherapy0
Bilirubin, Increase to ++++
GroupValue95% CI
Dostarlimab + Chemotherapy0
Pembrolizumab + Chemotherapy0
Glucose, No Change/Decreased
GroupValue95% CI
Dostarlimab + Chemotherapy79
Pembrolizumab + Chemotherapy57
Glucose, Increase to TRACE
GroupValue95% CI
Dostarlimab + Chemotherapy2
Pembrolizumab + Chemotherapy1
Change From Baseline (CFB) in Thyroid Functions: Free Triiodothyronine (T3) and Free Thyroxine (T4) Secondary · Up to approximately 46 months

Blood samples were collected for the assessment Free Triiodothyronine (T3) and Free Thyroxine (T4).

Triiodothyronine, Free, Baseline
GroupValue95% CI
Dostarlimab + Chemotherapy4.48026± 1.638746
Pembrolizumab + Chemotherapy4.48540± 1.066597
Triiodothyronine, Free, CFB to Cycle 2 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.12423± 2.071042
Pembrolizumab + Chemotherapy-0.24330± 1.026993
Triiodothyronine, Free, CFB to Cycle 4 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.00187± 2.206972
Pembrolizumab + Chemotherapy-0.11796± 1.413190
Triiodothyronine, Free, CFB to Cycle 6 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.15030± 2.128584
Pembrolizumab + Chemotherapy-0.37705± 1.117516
Triiodothyronine, Free, CFB to Cycle 8 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy0.11483± 2.738875
Pembrolizumab + Chemotherapy-0.43073± 1.123017
Triiodothyronine, Free, CFB to Cycle 10 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.25993± 2.187046
Pembrolizumab + Chemotherapy-0.23819± 1.273369
Triiodothyronine, Free, CFB to Cycle 12 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.04347± 2.817465
Pembrolizumab + Chemotherapy5.82171± 34.328615
Triiodothyronine, Free, CFB to Cycle 14 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.61895± 2.558169
Pembrolizumab + Chemotherapy-0.33501± 1.597219
Change From Baseline in Thyroid Function: Thyrotropin (TSH) Secondary · Up to approximately 46 months

Blood samples were collected for the assessment of Thyroid Function Thyrotropin (TSH).

Baseline
GroupValue95% CI
Dostarlimab + Chemotherapy1.853± 1.8354
Pembrolizumab + Chemotherapy1.904± 1.7421
CFB to Cycle 2 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy0.225± 3.7642
Pembrolizumab + Chemotherapy-0.497± 1.7405
CFB to Cycle 4 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy1.285± 9.4283
Pembrolizumab + Chemotherapy-0.622± 1.7892
CFB to Cycle 6 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy1.123± 8.4596
Pembrolizumab + Chemotherapy2.006± 21.0213
CFB to Cycle 8 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy2.454± 9.7235
Pembrolizumab + Chemotherapy2.648± 22.9952
CFB to Cycle 10 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy3.233± 12.1571
Pembrolizumab + Chemotherapy1.986± 12.8377
CFB to Cycle 12 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy2.448± 9.8590
Pembrolizumab + Chemotherapy1.138± 10.9780
CFB to Cycle 14 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy1.282± 4.2566
Pembrolizumab + Chemotherapy1.734± 9.0539
Change From Baseline in Thyroid Functions: Triiodothyronine (T3) and Thyroxine (T4) Secondary · Up to approximately 46 months

Blood samples were collected for the assessment of Triiodothyronine (T3) and Thyroxine (T4).

Triiodothyronine, Baseline
GroupValue95% CI
Dostarlimab + Chemotherapy1.68399± 0.308404
Pembrolizumab + Chemotherapy1.48287± 0.526037
Triiodothyronine, CFB to Cycle 2 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy0.06903± 0.172873
Pembrolizumab + Chemotherapy-0.58292
Triiodothyronine, CFB to Cycle 4 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.41878± 0.353613
Triiodothyronine, CFB to Cycle 6 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy-0.21476
Thyroxine, Baseline
GroupValue95% CI
Dostarlimab + Chemotherapy72.72912± 46.845564
Pembrolizumab + Chemotherapy85.29069± 38.027652
Thyroxine, CFB to Cycle 2 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy16.06393± 38.489073
Pembrolizumab + Chemotherapy-3.12689± 11.544100
Thyroxine, CFB to Cycle 4 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy10.16002± 47.746764
Pembrolizumab + Chemotherapy12.22592± 30.578995
Thyroxine, CFB to Cycle 6 Day 1
GroupValue95% CI
Dostarlimab + Chemotherapy9.83083± 30.658114
Pembrolizumab + Chemotherapy-2.45916± 27.497527
Number of Participants With Worst-case Grade Change From Baseline in Diastolic Blood Pressure (DBP) and Systolic Blood Pressure (SBP) Secondary · Up to approximately 46 months

DBP and SBP were measured in a semi-supine position after 5 minutes rest. Grades were derived based on numeric criteria as defined in Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Systolic Blood Pressure (SBP): Grade 0 (\<120 Millimetre of mercury (mmHg)), Grade 1 (120-139 mmHg), Grade 2 (140-159 mmHg), Grade 3 (\>=160 mmHg). Diastolic Blood Pressure (DBP): Grade 0 (\<80 mmHg), Grade 1 (80-89 mmHg), Grade 2 (90-99 mmHg), Grade 3 (\>=100 mmHg). An increase is defined as an increase in the CTCAE grade relative to the Baseline grade. Only those participants with grade increa

DBP, Increase to Grade 1
GroupValue95% CI
Dostarlimab + Chemotherapy36
Pembrolizumab + Chemotherapy27
DBP, Increase to Grade 2
GroupValue95% CI
Dostarlimab + Chemotherapy35
Pembrolizumab + Chemotherapy25
DBP, Increase to Grade 3
GroupValue95% CI
Dostarlimab + Chemotherapy6
Pembrolizumab + Chemotherapy7
SBP, Increase to Grade 1
GroupValue95% CI
Dostarlimab + Chemotherapy24
Pembrolizumab + Chemotherapy18
SBP, Increase to Grade 2
GroupValue95% CI
Dostarlimab + Chemotherapy34
Pembrolizumab + Chemotherapy24
SBP, Increase to Grade 3
GroupValue95% CI
Dostarlimab + Chemotherapy8
Pembrolizumab + Chemotherapy11

Adverse events — posted to ClinicalTrials.gov

Time frame: All cause mortality, non-serious adverse events (Non-SAEs) and serious adverse events (SAEs) were collected from Day 1 and up to approximately 46 months.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Dostarlimab + Chemotherapy
Serious: 51/121 (42%)
Deaths: 80/121
Pembrolizumab + Chemotherapy
Serious: 61/122 (50%)
Deaths: 91/122

Serious adverse events (102 terms)

ReactionSystemDostarlimab + ChemotherapyPembrolizumab + Chemotherapy
PneumoniaInfections and infestations
AnaemiaBlood and lymphatic system disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
PneumonitisRespiratory, thoracic and mediastinal disorders
Febrile neutropeniaBlood and lymphatic system disorders
PyrexiaGeneral disorders
COVID-19Infections and infestations
Pleural effusionRespiratory, thoracic and mediastinal disorders
NeutropeniaBlood and lymphatic system disorders
ThrombocytopeniaBlood and lymphatic system disorders
AstheniaGeneral disorders
Sudden deathGeneral disorders
Respiratory tract infectionInfections and infestations
Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders
HaemoptysisRespiratory, thoracic and mediastinal disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
PancytopeniaBlood and lymphatic system disorders
Cardiac arrestCardiac disorders
Pericardial effusionCardiac disorders
ColitisGastrointestinal disorders
ConstipationGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
PainGeneral disorders
SepsisInfections and infestations
Septic shockInfections and infestations
Other adverse events (44 terms — click to expand)

ReactionSystemDostarlimab + ChemotherapyPembrolizumab + Chemotherapy
AnaemiaBlood and lymphatic system disorders
AstheniaGeneral disorders
NauseaGastrointestinal disorders
ConstipationGastrointestinal disorders
CoughRespiratory, thoracic and mediastinal disorders
NeutropeniaBlood and lymphatic system disorders
VomitingGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
DiarrhoeaGastrointestinal disorders
Blood creatinine increasedInvestigations
FatigueGeneral disorders
RashSkin and subcutaneous tissue disorders
PyrexiaGeneral disorders
Alanine aminotransferase increasedInvestigations
Back painMusculoskeletal and connective tissue disorders
ThrombocytopeniaBlood and lymphatic system disorders
Oedema peripheralGeneral disorders
PruritusSkin and subcutaneous tissue disorders
Respiratory tract infectionInfections and infestations
Aspartate aminotransferase increasedInvestigations
HypothyroidismEndocrine disorders
ArthralgiaMusculoskeletal and connective tissue disorders
COVID-19Infections and infestations
Platelet count decreasedInvestigations
Weight decreasedInvestigations
HypomagnesaemiaMetabolism and nutrition disorders
Musculoskeletal chest painMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
HeadacheNervous system disorders
HypertensionVascular disorders
HyperthyroidismEndocrine disorders
StomatitisGastrointestinal disorders
Chest painGeneral disorders
ConjunctivitisInfections and infestations
PneumoniaInfections and infestations
Blood alkaline phosphatase increasedInvestigations
Gamma-glutamyltransferase increasedInvestigations
HyperglycaemiaMetabolism and nutrition disorders
Mucosal inflammationGeneral disorders

Most-reported serious reactions: Pneumonia, Anaemia, Dyspnoea, Pneumonitis, Febrile neutropenia, Pyrexia, COVID-19, Pleural effusion.

Data from ClinicalTrials.gov NCT04581824 adverse events section.

Sponsor's own description

NSCLC comprises of approximately 84 percent (%) of all lung cancers and is often diagnosed at advanced stage due to poor prognosis. Dostarlimab is an immunoglobulin G (IgG)4 kappa humanized monoclonal antibody (mAb) that binds with high affinity to programmed cell death protein 1 (PD 1), resulting in inhibition of binding to programmed death ligand 1 (PD L1) and programmed death ligand 2 (PD L2). This study aims to compare the efficacy and safety PD-1 inhibitors dostarlimab and pembrolizumab, when administered in combination with chemotherapy (pemetrexed, cisplatin and carboplatin), in participants with non-squamous NSCLC without a known sensitizing epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), or receptor tyrosine kinase-1 (ROS-1) mutation, BRAF V600E mutation, or other genomic aberration for which an approved targeted therapy is available. A total of approximately 240 participants will be enrolled in the study for a period of 5 years.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Dostarlimab: A Review.
    Costa B, Vale N. · · 2022 · cited 39× · PMID 35892341 · DOI 10.3390/biom12081031
  2. Dostarlimab or pembrolizumab plus chemotherapy in previously untreated metastatic non-squamous non-small cell lung cancer: the randomized PERLA phase II trial.
    Lim SM, Peters S, Ortega Granados AL, Pinto GDJ, et al · · 2023 · cited 22× · PMID 37951954 · DOI 10.1038/s41467-023-42900-4
  3. Retrospective analysis of the preparation and application of immunotherapy in cancer treatment (Review).
    Lu J, Ding J, Liu Z, Chen T. · · 2022 · cited 14× · PMID 34981814 · DOI 10.3892/ijo.2022.5302
  4. Immunotherapy in lung cancer brain metastases.
    Paisana E, Cascão R, Alvoeiro M, Félix F, et al · · 2025 · cited 8× · PMID 40328894 · DOI 10.1038/s41698-025-00901-0
  5. Drug resistance mechanism and reversal strategy in lung cancer immunotherapy.
    Xu Y, Liu Y, Ge Y, Li H, et al · · 2023 · cited 8× · PMID 37795038 · DOI 10.3389/fphar.2023.1230824
  6. Current Landscape of Immunotherapy Trials Involving the Programmed Cell Death Protein 1/Programmed Death-Ligand 1 Axis in Intrathoracic Tumors.
    Kareff SA, Samtani S, Burotto M, Prasad V, et al · · 2021 · cited 3× · PMID 34590006 · DOI 10.1016/j.jtocrr.2021.100149
  7. Development of a Joint Tumor Size-Overall Survival Modeling and Simulation Framework Supporting Oncology Development Decision-Making.
    Struemper H, Rathi C, Muliaditan M, Goulooze SC, et al · · 2025 · cited 2× · PMID 39985158 · DOI 10.1002/psp4.70002
  8. Patient-reported outcomes in patients with metastatic non-squamous non-small cell lung cancer from the randomized Phase II PERLA trial comparing first-line chemotherapy plus dostarlimab or pembrolizumab.
    Reck M, Granados ALO, de Marinis F, Meyers O, et al · · 2024 · cited 1× · PMID 39378565 · DOI 10.1016/j.ejca.2024.115050

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