ASCO 2016: Study Finds Use of Mobile Web App Associated With Improved Outcomes in Lung Cancer
A Web-mediated follow-up application (app; Moovcare™) improved advanced lung cancer survival, according to a French multicenter randomized phase III study. Researchers analyzed the association and evolution of self-reported clinical symptoms over time. The median overall survival of patients who used the application was 19 months, compared with 12 months for those who received standard follow-up care. Patient quality of life was also better among patients who used the app. The study was presented by Denis et al at the 2016 ASCO Annual Meeting (Abstract LBA9006).
“Through personalized follow-up using this convenient and simple online application, we can detect complications and signs of relapse and offer appropriate care earlier,” said lead study author Fabrice Denis, MD, PhD, a researcher at the Institut Inter-regional de Cancérologie Jean Bernard in Le Mans, France. “This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits to their oncologist.”
About the Study
After completing initial chemotherapy, radiation therapy, or surgery, 133 patients with stage III/IV lung cancer were randomly assigned to Web-mediated follow-up or standard follow-up. The standard follow-up included doctor visits and computed tomography (CT) scans every 3 to 6 months (or more often at the researcher’s discretion).
Patients in the Web-application group had the same schedule of planned doctor visits but three times fewer scheduled scans. They used the Web application to self-assess symptoms weekly. Caregivers could also enter data on behalf of the patients. The application analyzed 12 symptoms and reported results to the oncologist. An algorithm assessed specific changes in symptoms and triggered e-mail alerts for the doctor, who would then confirm the need for anticipated exams/visits to adapt cancer treatment, including supportive care options.
Key Findings
At 1 year, 75% of patients were still alive in the Web-application group, compared with 49% in the standard follow-up group. The study was stopped at planned interim analysis because of good results.
Relapse rates were similar in both groups: 51% and 49% in the standard and Web-application groups, respectively. The performance status at the time of relapse was good in the Web-application group, so the majority (74%) of those patients were able to receive the full recommended treatment for the recurrence. In contrast, only one-third of patients in the standard follow-up group were well enough to receive optimal treatment for cancer recurrence.
Overall quality of life, assessed using standard quality-of-life questionnaires FACT-L, FACT G, and TOI, was better in the Web-application group. Web-application follow-up also reduced the average number of imaging tests per patient per year by 50%.
According to the authors, this is the first randomized trial showing a major improvement in survival with Web-mediated follow-up vs standard follow-up. It is also the first time an algorithm for early detection of a symptomatic relapse or complication was used to trigger early supportive care or treatment.
In addition, review of patient-reported symptoms did not add burden to the doctors. On average, it took oncologists 15 minutes per week to follow 60 patients, and use of the app decreased the frequency of patient phone calls to the office.
This study received funding from the Institut de Cancérologie de l'Ouest/Sephira Inc. and Sivan Innovation, the maker of the Moovcare application.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
