2017 ASCO Annual Meeting!
Session: Plenary Session Including the Science of Oncology Award and Lecture
Type: Plenary Session
Time: Sunday June 4, 1:00 PM to 4:00 PM
Location: Hall B1
Overall survival results of a randomized trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment.
Health Services Research, Clinical Informatics, and Quality of Care
2017 ASCO Annual Meeting
J Clin Oncol 35, 2017 (suppl; abstr LBA2)
Author(s): Ethan M. Basch, Allison Mary Deal, Amylou C. Dueck, Antonia Vickery Bennett, Thomas Michael Atkinson, Howard I. Scher, Mark G. Kris, Clifford A. Hudis, Paul Sabbatini, Dorothy Dulko, Lauren J. Rogak, Allison Emily Barz, Deborah Schrag; The University of North Carolina at Chapel Hill, Chapel Hill, NC; Biostatistics Core Facility, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Mayo Clinic, Scottsdale, AZ; University of North Carolina, Chapel Hill, NC; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; Memorial Sloan Kettering Cancer Center and Weil Cornell Medical College, New York, NY; Children's Hospital of Philadelphia, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA
Background: We previously reported significant benefits in quality of life, patient satisfaction, and emergency room utilization outcomes from a large single-center randomized controlled trial comparing web-based symptom monitoring with patient-reported outcomes (PROs) vs. usual care in patients receiving chemotherapy for metastatic solid tumors (Clinicaltrials.gov: NCT00578006). We now present overall survival results from this trial. Methods: Patients receiving routine outpatient chemotherapy for metastatic solid tumors at Memorial Sloan Kettering Cancer Center were randomly assigned to self-report 12 common symptoms via tablet computers (“PRO intervention”), or to usual care. Treating physicians received symptom printouts at visits and nurses received email alerts when participants reported severe or worsening symptoms. Overall survival was tabulated based on medical records and Social Security Death Index data, estimated using the Kaplan-Meier method, and compared between arms using a log-rank test and Cox proportional hazards regression adjusting for age, sex, race, education level, and cancer type. Results: Between September 2007 and January 2011, 766 patients were randomized, with median age 61 (range 26-91), 86% white, 58% female, and 22% with less than high school education. Cancer types included genitourinary (32% of patients), gynecologic (23%), breast (19%), and lung cancer (26%). Survival results were assessed in June 2016 after a median follow up of 7 years and 517/766 (67%) of participants had died. Median overall survival in the PRO intervention arm was 5 months longer than the control arm (31.2 vs. 26.0 months, p = 0.03). In the multivariable model, results remained statistically significant with a hazard ratio of 0.832 (p = 0.04; 95% CI; 0.696, 0.995). Conclusions: Systematic symptom monitoring during outpatient chemotherapy using web-based patient-reported outcomes confers overall survival benefits. These single-center results are being further evaluated in a national multicenter implementation trial. Clinical trial information: NCT00578006