The Eastern Cooperative Oncology Group Performance Status (ECOG PS) has long been a vital tool in guiding therapeutic decisions. However, its subjective nature often leads to discrepancies among evaluators. Seeking to address this issue, a study published today in JAMA Oncology explored the potential of objectively measuring physical activity as an alternative means of assessing patients’ health status and predicting survival outcomes.
Led by Dr. Kentaro Ito and his team at Matsusaka Municipal Hospital in Mie, Japan, the study enrolled 119 patients with advanced lung cancer who were scheduled to receive systemic therapy. Participants wore a wearable monitoring device called amuelink (Sony) for up to 14 days to measure various physical activity metrics, including metabolic equivalent tasks, distance walked, and number of steps taken. Concurrently, their ECOG PS was assessed at enrolment.
The findings of the study revealed intriguing insights. Mean distance walked (MDW) emerged as the most promising metric for classifying patients with an ECOG PS of 2 or higher, exhibiting an impressive diagnostic value with an area under the curve (AUC) of 0.818. Furthermore, MDW was significantly associated with 6-month survival outcomes, indicating its potential as a prognostic indicator.
Survival analysis based on MDW thresholds demonstrated a statistically significant difference in overall survival between higher- and lower-activity groups. This suggests that physical activity levels, as measured by wearable devices, could offer valuable insights into patients’ prognoses, independent of other factors such as age, sex, or smoking status.
While the study provides compelling evidence of the association between physical activity and health status in advanced lung cancer patients, it also acknowledges certain limitations. The follow-up period for survival analysis was deemed insufficient, and the enrolment of patients with poor ECOG PS was limited, warranting further investigation in larger cohorts.
Dr. Ito and his team emphasize that while physical activity measurements show promise as complementary data for ECOG PS scoring, they do not propose replacing the established scoring system. Instead, they advocate for the integration of objectively measured physical activity into the assessment process to enhance its accuracy and prognostic value.
The study underscores the potential of wearable technology in revolutionizing cancer care by providing clinicians with objective data to supplement subjective assessments. As further research confirms the findings and addresses existing limitations, wearable devices could become indispensable tools in tailoring treatment strategies and improving outcomes for patients with advanced lung cancer.
