According to results from a post hoc analysis of the SYMPRO-Lung trial published in The Lancet Oncology, weekly patient-reported outcome (PRO) symptom monitoring may be associated with improved long-term overall survival among patients across all stages of lung cancer. Hassing et al reported that median overall survival was 5 months longer in the intervention group than in the control group.
“These findings underscore the value of implementing PRO symptom monitoring within routine care for patients with lung cancer,” the investigators wrote.
Study Details
The multicenter, stepped-wedge, cluster-randomized SYMPRO-Lung trial was conducted across 14 medical centers in the Netherlands. Eligible patients were aged at least 18 years, had newly diagnosed or recurrent stage I to IV lung cancer that was cytologically or histologically confirmed or radiologically suspected, and were starting a new treatment.
All participating hospitals began with a control period in which patients received standard care. According to a computer-generated randomization sequence, hospitals crossed over at predefined time points to the intervention period, during which patients completed weekly online symptom assessments for 1 year.
The overall trial’s primary outcome was health-related quality of life, which has been previously reported. This post hoc analysis evaluated long-term overall and progression-free survival, with overall survival designated as the primary outcome.
Of the 515 enrolled patients, 446 (87%) were included in the post hoc analysis. Of these, 235 (53%) were assigned to the pooled intervention group and 211 (47%) to the control group.
Key Findings
Median overall survival was 26 months with PRO symptom monitoring and 21 months with standard care, after a median follow-up of 50 months. Based on analyses adjusting for confounders, the investigators reported that PRO symptom monitoring may be associated with improved overall survival (hazard ratio [HR] = 0.80; P = .049).
No significant difference in progression-free survival was observed between PRO symptom monitoring and standard care after adjustment for confounders (HR = 0.86; P = .18).
“This post hoc survival analysis of the SYMPRO-Lung trial shows that PRO symptom monitoring might be associated with a long-term overall survival benefit in patients with lung cancer,” the investigators concluded.
Looking ahead, they wrote, “In future research, we will evaluate the cost-effectiveness of PRO symptom monitoring and examine its effects on health care usage.”
Iris Walraven, PhD, of Radboud University Medical Center, Nijmegen, the Netherlands, is the corresponding author of the article in The Lancet Oncology.
DISCLOSURE: The study was funded by Roche Netherlands, Stichting Kwaliteitsgelden Medisch Specialisten, and Zorginnovatiefonds. The study authors reported no conflicts of interest.
