Performance Status Strongly Predicts Survival in mCRPC – Renal and Urology News

Patients with metastatic castration-resistant prostate cancer (mCRPC) who have a higher vs lower score on the Eastern Cooperative Oncology Group performance status (ECOG PS) scale are at increased risk for early death, research confirms.

In a systematic review and meta-analysis of 75 studies (72 on mCRPC; 3 on metastatic castration-sensitive disease) involving 32,298 patients, the risk for all-cause mortality was significantly increased 2.1-fold among men with mCRPC who had an ECOG PS of 2 or more versus less than 2, Jonathan Assayag, PhD, MSc, of Pfizer in New York, New York, and colleagues reported in Frontiers in Oncology. On the ECOG scale, the higher the score, the worse a patient’s functioning. For example, an ECOG score of 0 indicates that a patient is fully active and capable of all functioning without restriction, whereas an ECOG score of 4 signifies a patient who is completely disabled and unable to perform any self-care.

The risk estimate for early mortality among patients with mCRPC was a significant 2.0-fold higher using real-world data studies compared with 1.3-fold higher using clinical trial data among men with a higher vs lower ECOG PS, using a value of 1 as the threshold. Receipt of chemotherapy did not alter these results.

More studies are needed to clarify the influence of ECOG PS on survival in metastatic castration-sensitive prostate cancer.

According to Dr Assayag’s team, “the results of this study provide clinical trial as well as real-world estimates of the association of ECOG PS with mortality. This can be useful when assessing the impact of key clinical characteristics, such as ECOG PS, that are often not available or partly missing in administrative claims databases and electronic health records.”

Disclosure: This research was supported by Pfizer Inc. Please see the original reference for a full list of disclosures.