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Observational Study
. 2024 May 1;10(5):648-651.
doi: 10.1001/jamaoncol.2024.0023.

Physical Activity Using a Wearable Device as an Alternative to Performance Status in Patients With Advanced Lung Cancer

Kentaro Ito  1   2 , Yuta Suzuki  1 , Tadashi Sakaguchi  1 , Kentaro Fujiwara  1 , Yoichi Nishii  1 , Hiroki Yasui  1 , Osamu Taguchi  1 , Osamu Hataji  1
Affiliations
Observational Study

Physical Activity Using a Wearable Device as an Alternative to Performance Status in Patients With Advanced Lung Cancer

Kentaro Ito et al. JAMA Oncol. .

Abstract

Importance: The Eastern Cooperative Oncology Group Performance Status (ECOG PS) is extensively used to guide treatment decisions in patients with advanced lung cancer. However, its assessment is subjective, potentially leading to discordance among observers.

Objective: To investigate the association between measured physical activity and ECOG PS, as well as the potential prognostic value of physical activity measurements in patients with advanced lung cancer.

Design, setting, and participants: This single-institution, prospective observational study enrolled 119 patients with advanced lung cancer scheduled to receive systemic therapy as outpatients at Matsusaka Municipal Hospital in Mie, Japan. Participants wore the wearable device amuelink (Sony) for up to 14 days to measure physical activity, including metabolic equivalent tasks, distance walked, and number of steps taken. ECOG PS was assessed at enrollment, which took place from December 2021 to August 2022.

Main outcomes and measures: The primary end point was estimating the area under the curve (AUC) for classification into ECOG PS of 2 or higher using physical activity measurements. An analysis of the association with survival was also conducted.

Results: Among the 119 patients (median [range] age, 72 (32-88) years; 71 [59.7%] male), mean distance walked (MDW) had the highest diagnostic value for classifying an ECOG PS of 2 or greater, with an AUC of 0.818 (95% CI, 0.703-0.934). Moreover, MDW was also associated with 6-month survival, with an AUC of 0.806 (95% CI, 0.694-0.918). Survival curves significantly diverged based on the MDW threshold, indicating a potential association with survival outcome (hazard ratio, 0.17; 95% CI, 0.05-0.57).

Conclusions and relevance: The cohort study suggests that MDW, as measured by a wearable device, was associated with ECOG PS and may serve as a predictor of health status alongside ECOG PS categories. It demonstrates the potential of objectively measured physical activity in complementing subjective ECOG PS assessments in patients with advanced lung cancer. Further research is needed to confirm the prognostic value of physical activity measurements.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Ito reported personal fees from Eli Lilly, Takeda Pharmaceutical, AstraZeneca, Boehringer Ingelheim, Chugai Pharmaceutical, Ono Pharmaceutical, Pfizer, MSD, Novartis, Daiichi Sankyo, Amgen, and Taiho Pharmaceutical outside the submitted work. Dr Yasui reported grants from Daiichi Sankyo, Novartis, AstraZeneca, Boehringer Ingelheim, Bayer, and GSK outside the submitted work. Dr Hataji reported personal fees from AstraZeneca, GSK, Novartis, Eli Lilly, Boehringer Ingelheim, Ono Pharmaceutical, Bristol Myers Squibb, Chugai Pharmaceutical, Takeda Pharmaceutical, Otsuka, Kyorin, Kracie, AbbVie, MSD, Janssen, Merck, Amgen, Pfizer, Asahi Kasei, Daiichi Sankyo, Nippon Kayaku, Sanofi, and Kyowa Kirin outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Receiver Operating Characteristic Curves and Area Under the Curve (AUC) Using Mean Distance Walked
ECOG PS indicates Eastern Cooperative Oncology Group Performance Status.
Figure 2.
Figure 2.. Kaplan-Meier Curves for Overall Survival
Overall survival curves based on mean distance walked (MDW) as daily physical activity and Eastern Cooperative Oncology Group Performance Status (ECOG PS). The threshold of MDW was calculated by receiver operating characteristic analysis. HR indicates hazard ratio.
See this image and copyright information in PMC

Comment on

References

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