Retrospective study shows that ECOG performance status impacts survival in metastatic lung cancer, suggesting treatment adjustment may be needed.
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.
No takes yet. Share an insight, caveat, or question.
Kapağan et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: