Impact of performance status on response and survival among patients receiving ICIs for advanced solid tumors

Clinical trials which led to the approval of immune checkpoint inhibitors (ICIs) for advanced malignancies have been almost exclusively performed in patients with good ECOG performance status (ECOG PS 0 or 1). A retrospective study at University of Nebraska Medical Center (Omaha) investigated the impact of performance status on response and survival among patients receiving ICIs for advanced malignancies. The overall response rate among patients with ECOG PS 0-1 was 23% compared with 8% among patients with ECOG PS ≥ 2 (p=0.005). The median overall survival was 12.6 months compared with 3.1% (p<0.001). The hospital referral rate was similar between the two groups (61.9% versus 67%; p=0.50) but patients with poor PS were more likely to have in-hospital death compared with the good PS group (28.6% versus 15.1%; p=0,035). The authors conclude that despite the appeal of ICIs in patients with advanced malignancy and poor PS, outcomes in this cohort were poor.