Lung cancer OS benefit with patient-reported symptom monitoring
medwireNews: A web-based patient-reported system for monitoring symptoms after treatment for lung cancer is associated with significantly better overall survival (OS) than standard scheduled imaging, trial results show.
“A potential mechanism of action is that symptoms suggesting adverse events or recurrence were detected earlier” as the patient-reported system “automatically triggered an alert email to the treating oncologist when patient-reported symptoms matched predefined criteria for severity and worsening,” say the study authors in a research letter published in JAMA.
Researcher Fabrice Denis (Institut Inter-régional de Cancérologie Jean Bernard, Le Mans, France) and co-investigators randomly assigned 121 stage IIA–IV lung cancer patients with nonprogressive disease after treatment to report on 13 common symptoms via a web-based system, on a weekly basis between visits, or undergo routine scheduled imaging every 3 to 6 months.
They note that a previous interim analysis – at a follow-up of 9 months – showed a significant OS benefit in favor of the patient-reported outcomes (PRO) group, a finding that holds true in the current final analysis conducted after 2 years.
Specifically, median OS was 22.5 months among patients who reported their symptoms and 14.9 months for those who underwent scheduled imaging, giving a significant hazard ratio (HR) of 0.59.
The results were similar even after accounting for the 10 patients who crossed over from the control to the PRO arm once the trial was terminated early on the recommendation of the data and safety monitoring company. Median OS was 22.5 and 13.5 months in the PRO and control groups, respectively, a significant difference equating to an HR of 0.50.
The trial included individuals who received tyrosine kinase inhibitors for metastatic disease, those who received maintenance treatment with antiangiogenic agents or chemotherapy, and those given immunotherapy. All participants were recruited from one of five centers in France.
The researchers highlight the restriction to French centers as a limitation, and also the inclusion of patients receiving maintenance therapy, “who may have had increased interactions with care teams.”
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