ArticleCancer2020
Impact of performance status on treatment outcomes: A real-world study of advanced urothelial cancer treated with immune checkpoint inhibitors.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of melanoma, version 3.0.Journal for immunotherapy of cancer · 2023Guideline
- Pretreatment clinical and hematologic prognostic factors of metastatic urothelial carcinoma treated with pembrolizumab: a systematic review and meta-analysis.International journal of clinical oncology · 2022Pooled it
- Nivolumab and ipilimumab in recurrent or refractory cancer of unknown primary: a phase II trial.Nature communications · 2023Trial
- Overall survival following palliative immune checkpoint inhibitor treatment according to ECOG performance status: a large registry-based study.Acta oncologica (Stockholm, Sweden) · 2026Article
- Effect of Liver Metastases on Survival in Microsatellite-Stable Metastatic Colorectal Cancer Treated with Immune Checkpoint Inhibitors.Cancer research communications · 2026Article
- A Review of the Latest Evidence on Prognostic Factors in Locally Advanced and Metastatic Urothelial Carcinoma Treated with Immune Checkpoint Inhibitors.Medicina (Kaunas, Lithuania) · 2025Review
- Clinical features as prognostic markers in patients with solid tumors treated with programmed cell death protein 1/programmed cell death-ligand 1 inhibitors: a retrospective cohort study.Translational cancer research · 2025Article
- Assessing the risks and benefits of investigational new drugs in adult phase-I oncology trials in China, 2013-2021.Investigational new drugs · 2025Review
- Article
- NRS2002 score as a prognostic factor in solid tumors treated with immune checkpoint inhibitor therapy: a real-world evidence analysis.Cancer biology & therapy · 2024Article
- Article
- Development and validation of a new tool to estimate early mortality in patients with advanced cancer treated with immunotherapy.Cancer immunology, immunotherapy : CII · 2024Observational
- Pembrolizumab in Patients with Advanced Urothelial Carcinoma with ECOG Performance Status 2: A Real-World Study from the ARON-2 Project.Targeted oncology · 2024Article
- Anticancer therapy at end-of-life: A retrospective cohort study.Acta oncologica (Stockholm, Sweden) · 2024Article
- Durvalumab Plus Gemcitabine and Cisplatin Versus Gemcitabine and Cisplatin in Biliary Tract Cancer: a Real-World Retrospective, Multicenter Study.Targeted oncology · 2024Article
- Outcomes with atezolizumab in metastatic urothelial cancer: real-world data from a single institution.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Review
- Prognostic Factors of Platinum-Refractory Advanced Urothelial Carcinoma Treated with Pembrolizumab.Cancers · 2023Article
- Mechanisms and biomarkers of immune-related adverse events in gastric cancer.European journal of medical research · 2023Review
- Pandemic Stressors and Adaptive Responses: A Longitudinal Analysis of the Quality of Life and Psychosocial Dynamics among Urothelial Cancer Patients.Journal of personalized medicine · 2023Article
- Prognostic Risk Stratification and End-of-Life Care Outcomes in Patients With Metastatic Melanoma Treated With Immune Checkpoint Inhibitors.The oncologist · 2023Article
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Authors and funding
37 authors.
Funding
Abstract
backgroundImmune checkpoint inhibitors (ICIs) represent an appealing treatment for patients with advanced urothelial cancer (aUC) and a poor performance status (PS). However, the benefit of ICIs for patients with a poor PS remains unknown. It was hypothesized that a poor Eastern Cooperative Oncology Group (ECOG) PS (≥2 vs 0-1) would correlate with shorter overall survival (OS) in patients receiving ICIs.
methodsIn this retrospective cohort study, clinicopathologic, treatment, and outcome data were collected for patients with aUC who were treated with ICIs at 18 institutions (2013-2019). The overall response rate (ORR) and OS were compared for patients with an ECOG PS of 0 to 1 and patients with an ECOG PS ≥ 2 at ICI initiation. The association between a new ICI in the last 30 and 90 days of life (DOL) and death location was also tested.
resultsOf the 519 patients treated with ICIs, 395 and 384 were included in OS and ORR analyses, respectively, with 26% and 24% having a PS ≥ 2. OS was higher in those with a PS of 0 to 1 than those with a PS ≥ 2 who were treated in the first line (median, 15.2 vs 7.2 months; hazard ratio [HR], 0.62; P = .01) but not in subsequent lines (median, 9.8 vs 8.2 months; HR, 0.78; P = .27). ORRs were similar for patients with a PS of 0 to 1 and patients with a PS ≥ 2 in both lines. Of the 288 patients who died, 10% and 32% started ICIs in the last 30 and 90 DOL, respectively. ICI initiation in the last 30 DOL was associated with increased odds of death in a hospital (odds ratio, 2.89; P = .04).
conclusionsDespite comparable ORRs, ICIs may not overcome the negative prognostic role of a poor PS, particularly in the first-line setting, and the initiation of ICIs in the last 30 DOL was associated with hospital death location.
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