ECOG Performance Status (Eastern Cooperative Oncology Group)
- A clinical tool used to assess a cancer patient’s functional status (ability to perform daily activities).
- Widely used to:
- Determine eligibility for chemotherapy, immunotherapy, and clinical trials.
- Guide dose intensity decisions.
- Estimate prognosis.
ECOG Scale
| ECOG Score | Definition | Clinical Interpretation |
|---|---|---|
| 0 | Fully active; no restrictions | Excellent performance status |
| 1 | Restricted in physically strenuous activity, but ambulatory and able to do light work | Mild symptoms, still functional |
| 2 | Ambulatory and capable of self-care, unable to work; up >50% of waking hours | Moderate symptoms; often eligible for systemic therapy |
| 3 | Capable of limited self-care; confined to bed/chair >50% of the day | Poor prognosis; usually not eligible for aggressive chemotherapy |
| 4 | Completely disabled; cannot carry on self-care; bedridden | Very poor prognosis; systemic therapy rarely appropriate |
| 5 | Dead | — |
Pharmacist Pearls
- ECOG 0–1 → patients usually eligible for most chemotherapy and targeted agents.
- ECOG 2 → sometimes eligible for systemic therapy (depends on trial/drug and comorbidities).
- ECOG ≥3 → usually best managed with supportive/palliative care, not intensive chemo.
- Many clinical trial protocols specify inclusion based on ECOG ≤1 or ≤2.