2194P - Prospective observational study of physical activity measurement using wearable device as an alternative to ECOG PS in patients with advanced lung cancer

Background

General health status is commonly evaluated using the ECOG PS scale in patients with solid tumors, including lung cancer patients, which often influences treatment decisions in practice. ECOG PS is classified into categories based on the reference associated with activities, estimation by questionnaire, or the subjective opinion of physicians. The aim of this study is to investigate the feasibility of measuring physical activities, and the association of ECOG PS or prognosis with the measurements of physical activities.

Methods

Patients treated with systemic therapy for lung cancer as outpatients in a single institution were enrolled in this study, Physical activities were estimated using amue link (SONY, Tokyo) as the werable device for up to 14 days. The measurements for analysis were the sum and mean of three estimated values from wearable device, (1)METS, (2)walking distance, and (3)walking steps. A comparative analysis of measured physical activities over the value of ECOG PS was primary endpoint, with the AUC for the classification of ECOG PS estimated by ROC analysis. An exploratory analysis of the predictive value for survival was performed, and survival curves were compared using the log-rank test (UMIN000047834).

Results

A total of 119 patients out of 121 enrolled patients were analyzed. Among the measurements, mean distance walked (MDW) was identified as candidate for predicting ECOG PS or prognosis with reference to the results by ANOVA and Kruskal-Wallis test. The AUC for classification into ECOG PS < 2 or ≥2 based on MDW was 0.818 [95%CI, 0.703 to 0.934] in the ROC analysis, and there was a significant difference in MDW between patients with PS 0 and PS 1 (p<0.001). Exploratory analysis showed that the AUC for classification into survival status at 6 months based on MDW was 0.830 [95%CI, 0.711 to 0.949] in the ROC analysis, and survival curves based on the threshold of MDW according to the ROC analysis were significantly different. (p<0.001).

Conclusions

Among the measurements, MDW was more correlated with ECOG PS, and the value of MDW has the potential to be a better predictor of general health status compared with ECOG PS categories.

Clinical trial identification

UMIN000047834.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

K. Ito: Financial Interests, Personal, Invited Speaker: Takeda, Eli Lilly, Chugai, AstraZeneca, Pfizer, Ono Pharmaceutical, MSD, Daiichi Sankyo, Nihon Kayaku. All other authors have declared no conflicts of interest.