Currently Viewing:
American Society of Clinical Oncology Annual Meeting
Persephone Trial: Cutting Trastuzumab Duration by Half Safer, Efficacious in HER2-Positive Breast Cancer
May 29, 2018
Remote Monitoring Can Reduce Radiation-Related Symptoms in Head and Neck Cancer
May 30, 2018
Despite USPSTF Recommendations, Lung Screening Rates Low Among Heavy Smokers
May 31, 2018
Nelarabine With Chemotherapy Boosted Outcomes in Pediatric and YA Patients With T-Cell Cancers
June 01, 2018
Dr Leonard B. Saltz on Deciding When a Patient Should Receive NGS Testing
June 02, 2018
Promising Early Phase Results With bb2121 CAR T Treatment in Relapsed Refractory Multiple Myeloma
June 02, 2018
Dr Peter Paul Yu Discusses the Impact of Health Information Technology in Oncology
June 02, 2018
Identifying Rational Immunotherapy Combinations for Glioblastoma: A Progress Report
June 02, 2018
Dr James Lin Chen Outlines Information Needs in Era of Precision Medicine
June 02, 2018
Ellen Miller Sonet Highlights Financial Burdens of Patients With Cancer
June 02, 2018
Utilization Management in Oncology: Current Strategies and a Path Forward
June 02, 2018
Immune Checkpoint Inhibitors Improve Outcomes in Mismatch Repair Deficient CRC, but Can Induce irAEs
June 02, 2018
ZUMA-1: Response to Axi-cel at Three Months Prognostic for Remission in B-cell Lymphoma
June 03, 2018
Cetuximab With Chemoradiation Worse Than Chemoradiation Alone in Older Patients With HNSCC
June 03, 2018
Dr Michael Thompson: The Role of Precision Medicine in the Community Setting
June 03, 2018
Dr Victoria Villaflor Outlines Challenges With Pursuing Precision Medicine
June 03, 2018
Clinical Trials: Sharing the Road With Real-World Evidence
June 04, 2018
Phase 3 TAILORx Results Confirm Chemotherapy Unnecessary in 70% of Women With Early-Stage Breast Cancer
June 04, 2018
KEYNOTE-042 Confirms First-Line Pembrolizumab Superior to Chemotherapy in PD-L1–Low Advanced NSCLC
June 04, 2018
Cemiplimab, in GOG 3016, Looks to Break New Ground for Immunotherapy in Cervical Cancer
June 04, 2018
Nearly Half of Patients With Metastatic CSCC Respond to Cemiplimab, on Fast Track at FDA
June 04, 2018
Opdivo Plus Chemo Boosts Progression-Free Survival 26% Over Chemo Alone in Late-Stage NSCLC
June 04, 2018
Managing Cancer-Related Pain in the Era of the Opioid Crisis
June 06, 2018
Discussing the Cost Burden of Cancer With Patients
June 06, 2018
Currently Reading
Study Underscores Value of PROs in Improving Lung Cancer Survival
June 07, 2018

Study Underscores Value of PROs in Improving Lung Cancer Survival

Surabhi Dangi-Garimella, PhD
At the 2018 American Society of Clinical Oncology Annual Meeting, a study conducted in France revealed the impact of electronic patient-reported outcomes (PROs) on survival among patients being treated for lung cancer. The study was presented by Fabrice Denis, MD, PhD, radiation oncologist at Institut Inter-regional de Cancérologie Jean Bernard, Le Mans, France.
A presentation by oncologist Ethan Basch, MD, from Memorial Sloan Kettering Cancer Center, during the plenary session at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, created a big splash. A patient self-reporting tool developed by his team, which allows patients to monitor and self-report their symptoms during routine treatment, helped improve overall survival among patients with solid tumors, compared with those patients who received usual care and routine monitoring.

At the 2018 ASCO Annual Meeting, a study conducted in France revealed the impact of electronic patient-reported outcomes (PROs) on survival among patients being treated for lung cancer. The study was presented by Fabrice Denis, MD, PhD, radiation oncologist at Institut Inter-regional de Cancérologie Jean Bernard, Le Mans, France.

Web-based monitoring of patients undergoing treatment for lung cancer is dual-pronged: not only is there evidence on improved survival, data also suggest improved resource utilization. For their current trial, patients with advanced-stage lung cancer without evidence of disease progression after initial treatment were randomly assigned to either:
  • An experimental arm of web-mediated follow-up based on weekly self-scoring of 13 common patient symptoms, or
  • A control arm of routine follow-up with 3-6 months repeated computed tomography (CT) scans.
The recruitment period was between June 2014 and January 2016; 133 patients were enrolled in the study, 121 of whom were in the intent-to-treat analysis. The majority of patients had stage III or IV disease.

When patients in the experimental arm self-scored their symptoms, the oncologist received an email alert if those symptoms matched predefined criteria. The primary outcome was overall survival (OS).

An interim analysis, the results of which were published late last year, found a 7-month median OS benefit associated with web-based monitoring to detect recurrence after initial treatment, compared with the scheduled imaging.1 The median OS was 19.0 months (95% CI, 12.5 to noncalculable) in the experimental arm and 12.0 months (95% CI, 8.6-16.4) in the control arm (P = .001) (hazard ratio [HR], 0.32; 95% CI, 0.15-0.67; P = .002).

“Based on the results of our interim analysis, we hypothesized that benefit was due to earlier detection of symptoms and relapses, prompting earlier treatment and supportive care,” Denis said. At the ASCO meeting, he presented final results from a 2-year follow-up of the patients.

The software used to assemble patient input, MoovCare, has been developed using the same rigorous standards as an implantable medical device, according to the software’s developer, SIVAN innovation. MoovCare is the “first real personalized follow-up in lung cancer,” Denis said.

“Via the web-mediated follow-up, the patient or caregiver provides a 12-symptom weekly report,” said Denis, which was prospectively assessed. So, the primary requirement is for the patient or caregiver to have internet access.  

Of the 34 patients alive in the control arm, 10 were eligible to cross over following the interim analysis. With 2 years of follow-up, and 70 deaths, the median OS was 23.0 months in the experimental arm and 14.8 months without adjustment for crossover in the control arm (HR, 0.62; 95% CI, 0.39-0.995; P = .048). Minus the crossover patients, the HR decreased further to 0.53 (95% CI, 0.33-0.85; P = .009), the authors found.

Following the longer follow-up, and despite the crossover of patients in the control arm into the experimental arm, the OS remained significantly larger with the web-mediated follow-up based on PROs than with routine disease follow-up by CT alone, Denis concluded.

He informed the audience of their team’s plan to conduct similar, larger trials in other cancers.

References
  1. Denis F, Lethrosne C, Pourel N, et al. Randomized trial comparing a web-mediated follow-up with routine surveillance in lung cancer patients. J Natl Cancer Inst. 2017;109(9). doi: 10.1093/jnci/djx029.
  2. Denis F, Basch EM, Lethrosne C, et al. Randomized trial comparing a web-mediated follow-up via patient-reported outcomes (PRO) vs. routine surveillance in lung cancer patients: Final results. J Clin Oncol. 2018;36,(suppl; abstract 6500).


Related Articles

Opdivo Plus Chemo Boosts Progression-Free Survival 26% Over Chemo Alone in Late-Stage NSCLC
Phase 3 TAILORx Results Confirm Chemotherapy Unnecessary in 70% of Women With Early-Stage Breast Cancer
KEYNOTE-042 Confirms First-Line Pembrolizumab Superior to Chemotherapy in PD-L1–Low Advanced NSCLC
Nearly Half of Patients With Metastatic CSCC Respond to Cemiplimab, on Fast Track at FDA
Managing Cancer-Related Pain in the Era of the Opioid Crisis
 
Copyright AJMC 2006-2018 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!