Pembrolizumab with or without platinum-based chemotherapy as first-line treatment in advanced NSCLC expressing PD-L1 ≥50%: The PERSEE randomized phase III trial (GFPC 01-2020).

In treatment-naïve stage IV or unresectable stage III NSCLC with PD-L1 ≥50%, adding platinum chemotherapy to pembrolizumab significantly improved median progression-free survival to 16.1 months vs 6.9.

• Why it matters: The field needed a head-to-head test of whether combining platinum chemotherapy with pembrolizumab provides better disease control than pembrolizumab alone in high–PD-L1 advanced NSCLC.
• What they did: In the multicenter PERSEE phase III trial (NCT04547504), 321 patients were randomized 1:1 to pembrolizumab alone or pembrolizumab plus four cycles of platinum-based induction chemotherapy, with PFS assessed by blinded central review using RECIST v1.1.
• The result: At a median follow-up of 38.7 months, combination therapy prolonged PFS (HR 0.56; P<0.001) and showed longer median overall survival (50.2 vs 29.9 months; HR 0.77), with higher grade ≥3 treatment-related adverse events (54% vs 19%).

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