INTRODUCTION: Metastatic non-small-cell lung cancer (mNSCLC) is a prevalent and life-threatening malignancy. This study aimed to investigate the impact of Eastern Cooperative Oncology Group performance status (ECOG PS) on survival in patients with mNSCLC who received nivolumab as second-line treatment after platinum-based chemotherapy. MATERIAL AND METHODS: This retrospective, single-center study included 272 adult patients with mNSCLC who received nivolumab as second-line therapy. ECOG PS, demographic characteristics, and disease-related characteristics were documented before nivolumab initiation. RESULTS: The median ages were 63 and 64 years in the ECOG PS 0–1 and ECOG PS 2 groups, respectively. The median follow-up duration was 7.95 months, with an interquartile range (IQR) of 4.14 to 15.37 months. Median progression-free survival (PFS) and overall survival (OS) were 3.6 months and 9.1 months, respectively. Multivariate analysis showed that ECOG PS 2 (HR = 1.48; 95% CI 1.06–2.07; p = 0.022), programmed death-ligand 1 (PD-L1) < 1% (HR = 1.51; 95% CI 1.09–2.09; p = 0.012), and de novo metastatic disease (HR = 1.66; 95% CI 1.17–2.36; p = 0.005) were associated with shorter PFS. Similarly, ECOG PS 2 (HR = 1.89; 95% CI 1.32–2.72; p < 0.001), PD-L1 < 1% (HR = 1.59; 95% CI 1.11–2.27; p = 0.011), and bone metastasis (HR = 1.98; 95% CI 1.38–2.84; p < 0.001) were also associated with reduced OS. CONCLUSIONS: ECOG PS was identified as a strong, independent prognostic factor for survival in patients with mNSCLC treated with nivolumab. In addition, negative PD-L1 expression, de novo metastatic presentation, and bone metastases were independently associated with poorer survival.
Kapağan et al. (Thu,) studied this question.