TY - JOUR
T1 - Remote Symptom Monitoring of Patients With Advanced Lung Cancer (The ProWide Study)
T2 - A Randomized Controlled Trial
AU - Danish Lung Cancer Group
AU - Friis, Rasmus Blechingberg
AU - Pappot, Helle
AU - Hjollund, Niels Henrik
AU - McCulloch, Tine
AU - Holt, Marianne Ingerslev
AU - Persson, Gitte Fredberg
AU - Wedervang, Kim
AU - Clausen, Malene Martini
AU - Wahlstrøm, Stine
AU - Hansen, Karin Holmskov
AU - Rasmussen, Torben Riis
AU - Dalton, Susanne Oksbjerg
AU - Jakobsen, Erik
AU - Linnet, Hanne
AU - Skuladottir, Halla
PY - 2024/12/10
Y1 - 2024/12/10
N2 - PURPOSE: Remote symptom monitoring of patients with cancer has previously shown potential for improving clinical outcomes. This study aimed to evaluate the effects of remote symptom monitoring in patients with lung cancer after palliative induction treatment.METHODS: In a Danish multicenter randomized controlled trial, patients were randomly assigned 1:1 to remote symptom monitoring (intervention arm) added to standard of care versus standard of care (control arm). Key eligibility criteria were stage III-IV lung cancer (small cell lung cancer and non-small cell lung cancer), Eastern Cooperative Oncology Group performance status ≤2, and no sign of disease progression after initial induction treatment. Patients in the intervention arm completed a weekly electronic questionnaire, assessing 14 common symptoms related to lung cancer. When a patient reported a severity exceeding a predefined threshold, the patient was subsequently contacted by phone to address potential clinical needs. Symptom monitoring was discontinued after progression. The primary outcome was overall survival (OS). Secondary measures included assessment of health-related quality of life (HRQoL).RESULTS: Of 494 randomly assigned patients, 240 were assigned to the intervention arm and 254 were assigned to the control arm. At a median follow-up of 3.5 years, symptom monitoring did not significantly improve OS compared with standard care (hazard ratio [HR], 0.93 [95% CI, 0.75 to 1.16]; P = .53). Exploratory subgroup analyses indicated improved survival for patients treated with carboplatin/vinorelbine (HR, 0.67 [95% CI, 0.45 to 0.98]; P = .04) and in departments with previous implementation of patient-reported outcomes (HR, 0.66 [95% CI, 0.44 to 0.98]; P = .04). HRQoL analyses did not reveal clinically meaningful effects.CONCLUSION: In the Danish health care system, remote symptom monitoring did not improve OS but led to modest improvements in HRQoL for patients with advanced lung cancer.
AB - PURPOSE: Remote symptom monitoring of patients with cancer has previously shown potential for improving clinical outcomes. This study aimed to evaluate the effects of remote symptom monitoring in patients with lung cancer after palliative induction treatment.METHODS: In a Danish multicenter randomized controlled trial, patients were randomly assigned 1:1 to remote symptom monitoring (intervention arm) added to standard of care versus standard of care (control arm). Key eligibility criteria were stage III-IV lung cancer (small cell lung cancer and non-small cell lung cancer), Eastern Cooperative Oncology Group performance status ≤2, and no sign of disease progression after initial induction treatment. Patients in the intervention arm completed a weekly electronic questionnaire, assessing 14 common symptoms related to lung cancer. When a patient reported a severity exceeding a predefined threshold, the patient was subsequently contacted by phone to address potential clinical needs. Symptom monitoring was discontinued after progression. The primary outcome was overall survival (OS). Secondary measures included assessment of health-related quality of life (HRQoL).RESULTS: Of 494 randomly assigned patients, 240 were assigned to the intervention arm and 254 were assigned to the control arm. At a median follow-up of 3.5 years, symptom monitoring did not significantly improve OS compared with standard care (hazard ratio [HR], 0.93 [95% CI, 0.75 to 1.16]; P = .53). Exploratory subgroup analyses indicated improved survival for patients treated with carboplatin/vinorelbine (HR, 0.67 [95% CI, 0.45 to 0.98]; P = .04) and in departments with previous implementation of patient-reported outcomes (HR, 0.66 [95% CI, 0.44 to 0.98]; P = .04). HRQoL analyses did not reveal clinically meaningful effects.CONCLUSION: In the Danish health care system, remote symptom monitoring did not improve OS but led to modest improvements in HRQoL for patients with advanced lung cancer.
U2 - 10.1200/OP-24-00562
DO - 10.1200/OP-24-00562
M3 - Article
C2 - 39657078
SN - 2688-1527
JO - JCO Oncology Practice
JF - JCO Oncology Practice
M1 - OP2400562
ER -