Web Application Extends Lung Cancer Survival

A Web-based application allows for earlier detection of relapse among patients with advanced lung cancer, improving survival by 7 months, according to a new study presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 3–7 in Chicago (abstract LBA9006).

Early supportive care also led to improved patient quality of life and early detection of dangerous medical conditions, said lead author Fabrice Denis, MD, PhD, a researcher at the Institut Inter-regional de Cancérologie Jean Bernard in Le Mans, France. He presented study results at a presscast.

“Through personalized follow-up using this convenient and simple online application, we can detect complications and signs of relapse and offer appropriate care earlier. This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits to their oncologist,” said Denis.

He noted that relapsing lung cancer patients often wait many weeks before a visit, which leads to degradation of their health and non-optimal therapy.

Denis led a French, multicenter, randomized, phase III study to analyze the association and evolution of self-reported clinical symptoms over time. After completing initial chemotherapy, radiation therapy, or surgery, 133 patients with stage III/IV lung cancer were randomly assigned to Web-based or standard follow-up. The standard follow-up included doctor visits and CT scans every 3 to 6 months, or more often at the researcher’s discretion.

Patients who used the Moovcare app to self-assess symptoms weekly had the same schedule of planned doctor visits, but three times fewer scheduled scans. 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 email alerts for the doctor, who would then confirm the need of anticipated exams or visits to adapt cancer treatment, including supportive care options.

For 121 evaluable patients, the median overall survival of those who used the app was 19 months as compared with 12 months for those who received standard follow-up. 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 these results.

Three-quarters of the patients who used the app were able to receive the full recommended treatment for a recurrence, while only one-third of patients in the standard follow-up group were well enough to receive optimal treatment.

Overall quality of life was better in the Web-based group, said Denis, and those patients also had half the average number of imaging tests per patient per year.

What’s more, on average, it took oncologists only 15 minutes per week to follow 60 patients, and automation decreased the frequency of patient phone calls to the office.

Denis said the researchers are adapting the algorithm for other cancers, and plan to conduct a randomized trial in lymphoma.

ASCO presscast moderator Patricia Ganz, MD, director of cancer prevention and control research at the UCLA Jonsson Comprehensive Cancer Center, commented, “If a drug caused this level of survival benefit, won’t we want to use it? This is an example of personalized medicine. It’s simple to collect information from the patient. Using tests when appropriate avoids waste.”