Does Performance Status Correlate With Survival in Pembrolizumab-Treated Patients With NSCLC?
Posted: Thursday, May 27, 2021
Daniel B. Costa, MD, PhD, of Beth Israel Deaconess Medical Center, Boston, and colleagues conducted a study to determine whether an Eastern Cooperative Oncology Group (ECOG) performance status score of at least 2 correlated with outcomes in non–small cell lung cancer (NSCLC) treated with pembrolizumab. The investigators discovered that an ECOG score of at least 2 was associated with poorer disease control, progression-free survival, and overall survival. Their findings were published in JAMA Network Open.
This retrospective study enrolled 74 patients who began treatment with pembrolizumab monotherapy for advanced NSCLC. Participants were separated into groups based on their ECOG performance status of 0 or 1 (45) and 2 or greater (29). Age, race, and body mass index were obtained from each participant. Each individual’s simplified comorbidity scores, PD-L1 tumor proportion scores, and tumor genomic profiles were also evaluated.
The median age of patients was 68.5 years; 48.7% were women, and 71.6% were White. A total of 29 participants were alive at the median follow-up of 19.4 months. Participants with a performance status score of at least 2 had a significantly lower disease control rate than those with a 0 to 1 (53.6% vs. 88.4%). These patients also had a shorter median progression-free survival (2.3 vs. 7.9 months) and a shorter median overall survival (4.1 vs. 23.2 months) than those with lower scores.
The objective response rate for those with a performance status score of 0 to 1 was 27.9%, whereas those with a performance status score of at least 2 were 17.9%. Immune-related adverse events affected 53.3% and 31.0% of patients with a score of 0 to 1 and a score of at least 2, respectively, but the difference did not reach statistical significance. Patients with ECOG performance scores of 2 or greater were less likely to receive any subsequent cancer-directed therapy beyond pembrolizumab monotherapy.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
